Inside Medicine: Stillbirths' rate, effects little changed

01/03/2013 12:00 AM

01/02/2013 4:18 PM

After waiting 24 weeks, Wendy was extremely excited about the birth of her first child. There were frequent trips to the store for clothes, a crib and various other items.

But one night Wendy began to experience cramps. She went to the hospital, where doctors monitored her fetus.

Suddenly, the staff realized her baby was in distress and things turned grim. They ushered her partner to a waiting room and rushed Wendy to the operating room for an emergency Caesarean section. The baby was born dead.

Wendy was still too groggy from anesthesia to understand the news, but the father's hopes and dreams were replaced with grief over the sudden end of their wonderful journey.

Each year more than 3 million babies are stillborn. And each birth leaves a trail of despair. Families grieve a stillbirth in very similar ways they do the death of any other child. Wendy feels emptiness and a profound guilt that she could not protect the baby.

Doctors tell Wendy "it is just one of those things" but she is not convinced. She questions everything in her life – was there was something she did to cause this death?

Wendy's grief flows to others – family, friends and neighbors. She hears the doctors and nurses talk as if there is nothing to worry about; they reassure her she will again get pregnant. Days, weeks pass. Wendy can think of nothing else.

There are some stillbirths that can be prevented, sometimes by simple measures such as good nutrition and good maternal health. We know that stillbirths are far more common among the poor, minorities and those who have limited access to prenatal care.

There are many causes for stillbirths including growth restriction, congenital problems and infections. Despite these factors, for the vast majority of stillbirths, we have no idea of their cause.

Over the past two decades the number of stillbirths has remained essentially constant despite advances in other areas of fetal and maternal medicine. By way of comparison, there are 10 times more stillbirths than there are deaths from sudden infant death syndrome, which receives far more research money and public attention.

Regardless of the cause, women and their partners who have suffered from a stillbirth need compassionate care not only at the time of the loss, but in the days and weeks that follow.

These days Wendy has a hard time getting out of bed each morning. She stays at home so she doesn't have to see her friends because she knows they'll all ask if she has had the baby.

We encouraged her to join a support group and talk to others who have gone through similar experiences, but she said she's not yet able to talk about it. There is still shame and self-blame.


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