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How can the risks and incidences of stillbirths be reduced?
The International Pregnancy and Infant Loss and Remembrance Day took place in October 2013. Doctors took this opportunity to highlight concerns about the standard of maternal care during pregnancy.
There is nothing worse for any parent than the loss of a child and in coming to terms with such a loss it’s important for parents to seek answers and information as to why their child died during pregnancy or childbirth. An Australian Professor recently spoke of the need to increase awareness of stillbirth and for greater discussion amongst our communities so as to improve understanding.
Professor Robinson stated that: “The unbearable sadness of losing a child is impossible to put into words. The tragedy is even greater given that many lost babies did not have to die.” The Professor suggested that with better medical care and monitoring during pregnancy deaths could be prevented, particularly with earlier delivery and careful assessment of placental sufficiency, if required.
She stated: “There are many things that expecting mums and their doctors can do. We need to ensure that optimal maternal health is maintained; detecting and managing slow fetal growth and diabetes in pregnancy is crucial. Regular checking of fetal movements can make a big difference.”
In the UK around 1 in 200 births are stillbirths, which is over 6,500 babies a year; over 90% of those babies have no genetic abnormality and a third are unexplained, with another third related to intra uterine growth restriction. The charity SANDS (stillbirth and neonatal death charity) state: “One in three stillbirths happen at or near term when babies could survive if they were delivered.” The charity seeks better understanding of how babies at risk can be prevented from dying in the womb. In particular they are funding a research project called AFFIRM which is looking at whether if mothers monitor fetal movements it will help to prevent stillbirths.
We as medical negligence solicitors have acted for clients with claims relating to the stillbirth of their babies because of failures to diagnose complications during pregnancy such as pre-eclampsia, placental insufficiency or abruption and gestational diabetes. In these cases we have proved that the failure to diagnose the complications during pregnancy was below an acceptable standard of medical treatment and therefore amounts to medical negligence. Such conditions are often treatable if diagnosed promptly or the option can be given for there to be earlier delivery of the baby, and the baby would survive. Our experience of such claims is that more can be done to reduce the number of stillbirths with adequate treatment during pregnancy to monitor for and diagnose complications.
Unfortunately under present UK law there is no legal obligation on a Coroner to hold an inquest as it is considered that as the baby never had independent ‘life’ outside its mother they cannot properly form the subject of an inquest. Therefore there is a separate stillbirth certificate, but not a normal death certificate.
The Courts in Northern Ireland are currently deliberating whether this stance is lawful, seeking answers to questions such as: ‘What is a person?’, ‘Is it possible to die before one has been born?’, ‘Is there a legal difference between life in the womb and life outside the womb?’” The judicial review proceedings relating to the death of Axel Desmond continue and are awaited with great interest.
It is extremely difficult for parents to come to terms with the death of their unborn child and it adds greatly to their distress to be informed that the Coroner will not investigate the circumstances leading to the death, particularly where concerns have been raised as to the standard of medical care provided during pregnancy and where it may be a stillbirth due to medical negligence. It is hoped that with better accountability, review and awareness of these tragic cases the rates of stillbirths in the UK can be significantly reduced.