Stillbirth rate 'unacceptably high' in Wales say AMs

The UK ranks 33rd worst out of 35 European countries when it comes to stillbirth rates

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An "unacceptably" high number of stillborn babies in Wales could be reduced by a series of small changes in care, an assembly committee says.

Around 180 babies are stillborn each year - a figure AMs said is too high given medical advances.

They say 60 babies' lives a year could be saved if procedures are tightened.

The health committee wants professionals to be trained in talking to grieving parents about consenting to post-mortem examinations.

Stillbirth is when a baby dies after 24 weeks of pregnancy but before birth.

The cause of death is unknown in almost half of cases.

The stillbirth rate in Wales has been between 4.2 and 5 per 1,000 births since the early 1990s.

It is a similar rate across the UK, which is higher than any other European country.

The assembly's cross-party health committee said matching the rate in Scandinavia would save at least 64 babies a year.

AMs held a one-day inquiry into stillbirths - the most common cause of child death in Wales - which heard from doctors, midwives, bereaved parents and campaigners.

A report recommends a series of small changes that could reduce the rate.

  • Expectant parents should have more information about stillbirths
  • More consistency in how babies are screened in the womb - some countries offer more ultrasound scans, while there are disagreements about whether a tape measure is the best way to check foetal growth
  • Parents should recognise reduced foetal movement as a warning sign of a risk of stillbirth, although they do not always get a clear clinical response
  • More government funding for research into stillbirths, seen to be lacking despite being more common than Down's syndrome and 10 times more common than cot death.

Committee chairman Mark Drakeford said: "It is Wales's most common form of child mortality. And yet we do not talk about it.

Analysis

This is a big issue in Wales and a big issue in the UK. The UK ranks 33rd worst out of 35 European countries when it comes to stillbirth rates.

It is the biggest cause of infant mortality there is - more common than cot deaths, 40 times more common than road accidents and 80 times more common that childhood meningitis.

In general child death rates have decreased in the UK over the last few years but the rate of stillbirth has remained, as the committee sys, stubbornly high.

That's why the health committee wanted to look at this issue to simply ask the question why are those rates so high and could more be done to prevent the deaths?

"As a committee we are in no doubt that the current rate of stillbirths in Wales is unacceptable."

The committee said the Welsh government should publish a plan of how it will tackle the low rate of post-mortem examinations carried out on stillborn babies.

The plan should include details of how staff will be trained so they can raise such a difficult issue with grieving parents.

In 2011, only 40.5% of parents consented to a post-mortem.

AMs were told the low uptake was partly due to a shortage of specialist pathologists. Wales has the equivalent of 1.2 fulltime perinatal pathologists.

Holding a post-mortem could delay a stillborn baby's funeral by at least two weeks, with a further six to eight-week wait for the results. But for adults, the process is completed in about 24 hours, the report says.The Welsh government said it would consider the findings of the inquiry.

A spokesperson said: "The National Stillbirth Working Group is working with health boards to improve communication skills amongst clinicians asking for parental consent for autopsy, as well as addressing avoidable factors in both lifestyle and management of pregnancy, and the monitoring of foetal growth and movements."

A clinical review of every stillbirth, which looks at family history, is undertaken by a Wales-wide survey.

The spokesperson said that the Welsh government wanted the data gathered from the survey to be as comprehensive as possible to increase knowledge about avoidable factors.

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