The scandal of stillbirths

I've found your posts interesting, sadie. If it's possible to make the same points as you have made without apportioning blame, I think they would go down better

What sort of monitoring (I mena, what needs to be monitored) makes a difference, anya, and how? Please.

You see, I think it's more than clear that this long standing problem is NOT
Government policy.It goes back too far for that. Not everything is the fault of the present government, however some may think that is the case!
I too, am off this thread now.

It's ridiculous to suggest cuts in services doesn't affect care. Without the midwives in post, who is doing the caring?

Perhaps I am being confrontational! The thing is, I object to someone repeatedly telling me not to raise politics. As far as this particular topic is concerned it's clear that some of the underlying problem is government policy.

Surely as grans we're mature enough to have a sensible discussion. Why do posters feel the need to dictate terms? I thought Gransnet ran the site.

This wasn't meant as a Tory bashing thread Sadiesnan or to talk about nurses on general wards etc.It's a sad topic ( as I know only too well, even if it happened a long time ago for me) and I also think you are being confrontational in your posts.

Throwing money at the NHS ( there has been plenty of that in the last 20 years) has obviously not improved the the high rate of still births in the UK.
Blaming austerity measures in place for the last few years has obviously nothing to do with it.It is ante natal practise that should change.As Anya says, at least half of the deaths take place in the womb.MIL09 makes a good point with her last sentence.

The safer staffing recommendation which pushed for a patient-nurse ratio of 8:1 was scrapped this year by health secretary Jeremy Hunt. As well as putting patients at risk, including on the labour wards, how effective will nurse training be if the wards are not staffed adequately?

This is yet another issue that implicates the government in it's failure to facilitate a safe NHS.

The advances in medical care does increase the survival rate of premature babies. I belong to a not for profit group Needles & Hooks Angels & preemies which provides clothing and blankets for special care units throughout the UK. If anyone would like to help there is a Facebook page which explains what we do

Obviously monitoring is essential but we need more midwives to do the monitoring.

The point raised by JessM about the withdrawal of bursaries is interesting. Schools of Nursing and Midwifery have always encouraged more mature students to apply, as they bring a wealth of life experience with them which is very valuable to the profession. With the withdrawal of the bursary I suspect the numbers of mature students applying will drop and perhaps applications from others will also be fewer. This is concerning, when you consider we already have a shortage of nurses, health visitors and midwives. We are already recruiting from abroad, which suggests we need to make our courses more appealing, not less.

We also need to encourage more mothers to take up the ante-natal care that is on offer. Those that refuse come from a variety of backgrounds. There are some middle class mothers who are into alternative ways of managing pregnancy and childbirth. There are teenage girls who simply don't understand the need, or sometimes don't even realise they're pregnant, or refuse to tell anyone due to worry about the consequences. Then there are those who are fearful of what the medical profession might say. I'm thinking of heavy smokers, drug abusers and those that abuse alcohol.

Just joined this discussion. Many health professionals within obstetrics and midwifery have been concerned for years about the stillbirth and neonatal death rate.
I have just retired but spent my career trying to give women the latest evidence based information. There is a political issue with the NHS but stillbirth also happens to the rich and famous using private medical care and to the medical and midwifery staff themselves.
Perhaps we need to focus on how other countries are able to reduce the rate and get on and make the changes needed.

It would seem from the above post that many people think that most stillbirths occur at delivery.

This is completely missing the point that at least half occur in the womb.

That is the point I'm trying to make about monitoring

I wonder how many stillbirths occur because all mums are now expected to go to hospital. I've had 3 children, and didn't want to go into hospital. Tbere were complications with my first pregnancy, due entirely to carelessness in my ante-natal hospital care, when my daughter was lucky to survive; for the second I was given no choice because they expected the same problems as with the first; - for the third my GP felt it was sensible because of my age; he booked me into the local "cottage hospital" type of facility, but they wouldn't take me because they felt I was too old to take the risk and again the birth was not at all straightforward. My midwide godmother was shocked at the careless attitude I experienced on all 3 occasions and would have been happier had I been given my wish, when, as she says, my own midwife would have been sufficiently experienced and knowledgeable to avoid the minor complications which, just because I was in hospital, turned into major ones!

How many stillbirths could be prevented

It's not my views which are of interest. It's the views of those experts working in that field. I watched the BBC programme 'Born Asleep* several months (?) ago and it left a lasting impression on how some of the simple methods, mentioned at the end of the above article, could prevent a large proportion of stillbirths.

It left me wondering why are these procedures not being used nationwide, when the cost is as little as 50p per mother. I'm pleased that they are standard procedure here in the West Midland area.

I suggest it's a distraction to blame "the management" and their salaries.
There has been a shortage of midwives in the UK for a long time. I think there is also a shortage of obstetric consultants (desperate where I live)
This select committee report is interesting. The sad fact is that politics has a powerful influence on health care.
According to the RCM there is stiff competition to gain a place on a course to train. And the places are limited by the amount of NHS funding. More places could be funded if shortage of midwives is a cause of stillbirth figures.
I note the plans to remove bursaries from student nurses and midwives.

www.parliament.uk/business/committees/committees-a-z/commons-select/public-accounts-committee/news/maternity-services-report/

Anya, I'd love to discuss this issue as it's really important. I'm trying my hardest to actually talk about the issues and I'm really interested in your views.

Please show where I've been confrontational? And I'll try to understand what you mean.

Why are you being so confrontational Sadie'snan?

This and many other issues are a direct result of 'austerity'.
The rich can pay for services the rest of us fall further down the ladder whilst Chief Executives of NHS Trusts, Academy Chains, and other services pay themselves huge salaries and bonuses with public money. We should all be fighting this.

Go on then Anya, tell us about the many factors which contribute to a poor outcome in pregnancy, I'm really interested.

Your first post seemed to suggest that you think " simple monitoring procedures which ought to be the norm across the NHS" is the main reason.

Whilst no doubt that view is relevant, it's interesting to discuss what's behind that. Why don't we all have the access to the same level of care?

As we have a Conservative government in power at present, they make the decisions about the NHS and hold the purse strings. It's kind of inevitable that questions might be asked about their management and leadership of the NHS over this issue. I don't really see how you can rule them out of the discussion.

Yes, you did ask us not to turn this into a political issue but the fact is, it is political.

Can you outline the recommendations in The Lancet for us please, as it would be useful on this thread and we can perhaps discuss each point.

D'you know Sadie given my background I could probably give a lecture on the 'many factors' which contribute to a poor outcome in pregnancy.

Why did I start this thread? Not for more Tory bashing, but to raise awareness of something that has been an issue for many, many years. I'm not dictating anything, I simply asked that please this didn't turn into a political issue. Of course, anything to do with the NHS has political implications but, given the subject matter and how long this has been an issue (under governments of different political flavours) I had hoped that we could actually discuss the recommendations in The Lancet.

I'm sorry you struggle to understand where I was coming from

*are complex

Anya - as with a lot of things, there's no single reason for stillbirths. Many factors contribute and although in an ideal world all women should access good care, it doesn't always happen.

Yes all women could access ante-natal care, but there are groups of women who choose not to.

Yes, all care should be good but it's not always good and the reasons for that complex.

I'm struggling to understand your posts. Did you want a discussion on this very important matter? If so then you cannot dictate what other people can contribute. If not, then why start a thread?

When my DGC were on the way, I was amazed to find that the free midwife-run antenatal classes we all attended back in the 80s were no more. There was some provision at Children's Centres in the most deprived areas, and the NCT classes, which had to be paid for and booked well in advance as they were over-subscribed. My DD and DDIL went to these, but I know other mums to be who missed out. I found the advice given at my classes invaluable, and I believe the lack of them must be detrimental to mother and baby health.

I must say I was also puzzled as to why, despite regular ante-natal checks, including one two days before he arrived, no one picked up on the fact that DGS3 would weigh in at well over 10 pounds, 3 pounds more than his brother. From what I've read since, this could have caused major problems during delivery.

When I lived in Edinburgh, I was 'next-door' to an area that had one of the highest infant mortality rates in Europe. The work of the local healthcare team was slowly making a difference (an impressive difference) and the way they were doing it was by raising awareness among women of child-bearing age of "pregnancy health" (lifestyle choices that make a difference to the health of the foetus, and so on). As I understand it, the difference was made by educating women, including by convincing them that coming to antenatal clinics was a good idea.

That sort of work does need funding. Extra funding even.

In early 1983 I was put in contact by my health visitor with a young immigrant Vietnamese woman. Her first child had been born in a refugee camp in HongKong. The second was due and my task was to try and prepare her (teach her some basic English) for a hospital birth in Edinburgh. She didn't want to go to hospital. Her husband delivered the baby and then called an ambulance. I got the impression she thought we made far too much fuss. I'm wondering if there is some of this in the West Midlands area the OP is talking about?

Here in the West Midlands stillbirths have dropped by 40%. It's not the ability to access ante-natal care - all expectant mothers can access anti-natal care- it's the level of care on offer. Very simple monitoring procedures, which simple aren't in place in some clinics.

Anyway, I've said all I want to on this thread as it's going the way of so many others, which, considering the sadness of the subject under discussion, I find unacceptable.

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Please try and watch one of the 'recorded' and available to view now debates held in Parliament, I think Nov 2015. I watched it live and 2 Conservative MP's told of their child being born as stillbirths. There are times when Parliament pulls together on both sides of the House and partisan politics is not on show, this debate was one of them.

Also look at Conservative Tracey Crouch and her campaign on stillbirths also Jeremy Hunts statement re stillbirths and government funding in November 2015.