Here is a story I found today about an organization called Sands based in the UK who is calling on Scotland’s Government to ensure that stillbirths and neonatal deaths are recognized as a “major health issue and addressed as a matter of urgency and priority.”

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A recent study published this week reveals that most hospitals, maternity care staff and physicians are insensitive in dealing with women experiencing pregnancy loss – probably not an unexpected finding to anyone who has lost a child through miscarriage, stillbirth or perinatal death. The study was conducted by the Association for Improvements in the Maternity Services – Ireland (AIMSI) and focused on women having miscarriages. Those surveyed reported receiving care for their miscarriage on the labor and delivery floor, right next to women at the end of a long pregnancy about to give birth to a living child, God willing. One of the respondents reported being traumatized by hearing the sounds of a busy delivery room as she was dealt the news she would lose her tiny baby to miscarriage.

Although the subject of the article centers on the mishandling of miscarriages, it brings back nightmarish memories of my own labor and delivery story – the silent birth of my first child, Nicolas, one week after his due date. After waiting patiently for 41 weeks, convinced we were out of the “danger zone,” i.e., the first trimester (oh, how naïve I was then), we went to the hospital on February 28, 2006, excited that labor had finally started, only to be told our son had “no heartbeat.” Lying next to me in the same room were two other laboring women, hooked up to Dopplers, the strong swoosh, swoosh, swoosh of their babies’ heartbeats echoing along with my sobs. I was finally taken to a private room and given Pitocin as my labor slowed. I was told my contractions stopped because usually babies help progress labor, but in my case… I wanted to tell them Nicolas wasn’t being difficult – he was dead.

I labored for about 23 hours, thankfully much of that time lost in a fog of pain and shock. But every now and then, from another room down the hall, the sweet, mocking sound of a newborn cry and the cheers of nurses would creep into my consciousness. Every now and then I would hear that strong swoosh next door and realize my nurses didn’t even bother to put a heartbeat monitor on me. The following day, in my recovery room, a nursing assistant came in with an sunny smile on his face and told me it was time to take my prenatal vitamin. I had just given my son’s body back to the nurse for the final time and was in no mood for false cheer. As he left the room with that damn pill still in the little Dixie cup, I glimpsed just outside my door a new mom and dad with their breathing baby bundled in an infant carrier, ready to go home. I could take no more and demanded to be released. I was given a prescription for Motrin for the physical pain and two anxiety pills for the emotional trauma that lie ahead (they were concerned I would take all the pills at once, so I only got two). The pharmacist congratulated me on the birth of my baby as she handed me my prescriptions, and all I could choke out was, “thank you.” My husband pulled the car around, and I climbed in, Nicolas’ empty car seat in the back. We went home and shut the door to Nicolas’ waiting nursery.

I wonder now if my experience would have been better if I were quietly taken to a room far enough away from the “normal” labor and delivery floor so I wouldn’t have heard those Doppler heartbeats and newborn cries, so I wouldn’t have seen living babies next to my dead son. I wonder if it’s asking too much to be treated respectfully but separately from other laboring women, to be handled a bit more sensitively and to be spared those painful reminders of what I would never have with Nicolas.

Just over a month ago, Janet Fraser lost her full-term baby while giving birth at her home in Australia. A critic of modern OB/GYN care and a leading advocate of home births, Fraser opted to deliver her child in a “free birth,” a home birth unassisted by medical professionals. The irony of this tragic event — an outspoken advocate of home birth losing her baby during a home birth — has not been lost on the media, and the subject of home birth’s safety has received more attention in the last month than is usual.

It is easy to see the appeal of home birth to those suspicious of Western medicine. Many studies have reported that medical interventions, such as episiotomies, forceps delivery and Cesarean sections, are too readily used. However, it is medical advances such as these that have turned the single most dangerous event in a woman’s life — pregnancy and childbirth — into something routine. Not too long ago, it was common for women and their babies to die during the process.

A recent study presented at the annual meeting of the Pediatric Academic Societies reports that home births have more than double the risks of complications and infant mortality than do births at hospitals where access to medications, oxygen and trained pediatric specialists are available. While Western medicine has its shortcomings and is imperfect, the risk to mother and child is much lower in a medically-assisted birth at a certified hospital. In the end, it does not matter how your child gets here or where he was born –only that you’re both alive.

SF Sexual Health Examiner: New study indicates hospital delivery safer for babies than home birth

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Every year in the United States, hundreds of newborn infants die from undiagnosed – yet treatable – congenital heart defects. These children are sent home from the labor and delivery floor with a clean bill of health, only to return days or weeks later to the emergency room with difficulty breathing and blue-tinged lips, hands and feet. Some of these infants are fortunate enough to receive life-saving surgery to correct their heart defects. Many others do not survive. While prenatal screenings, in the form of ultrasound, can pick up some of these congenital heart defects, as many as three-quarters go undiagnosed during pregnancy. And, during newborn screenings, nearly half of serious heart defects are missed as well.

A simple, noninvasive test exists that can screen newborn babies for critical heart defects within hours of their births. It does not require any special equipment or training, according to Dr. Darshak Sanghavi, a pediatric cardiologist, and has been shown to have a high success rate in other countries. For whatever reason, most hospitals in the United States are not currently performing this screening test, which consists of placing a small sensor on the baby’s toe to measure oxygen saturation. If your hospital is one of the thousands not offering this simple, but vitally important, screening test, make sure you specifically request it. It is called “pulse oximetry.” For more information, please refer to the following article reported in the New York Times Health Blog.

Screening Babies for Broken Hearts
In the middle of one night in August, a seemingly healthy 1-week-old infant named Ryan Olson suddenly began gasping for breath at home in Massachusetts, and his frantic parents rushed him to the hospital. There, emergency room doctors noted the critically ill baby had bluish feet and — even more worrisome — no pulse in his lower body. That almost certainly meant the boy had a “coarctation,” or blockage of his aorta, which is the key pipeline supplying oxygen-rich blood to the body. As the on-call pediatric cardiologist, I was urgently called in to help out. Read more

A study into the long-term consequences of the death of an infant on surviving siblings has recently been published. While the focus of the study involved infants who died in the neonatal intensive care unit (NICU), it seems the implications can also explain the affects of stillbirth, as well as the death of older babies, on living siblings. One of the most interesting findings shows that regardless of when the baby died – either before or after the surviving siblings were born – there was no change in how the living brothers and sisters dealt with the loss.

I have often wondered how Nicolas’ death will affect my living son, Christopher Nicolas, who was born three days shy of Nicolas’ first birthday in February 2007. My need to honor and celebrate Nicolas’ memory through displaying his photographs all over my home, lighting candles on important days, wearing special memorial jewelry – and simply speaking his name – has at times competed with my need to protect Christopher. My instinct tells me Christopher will be a better person for having known his brother, if only through my memories. But I worry that introducing the concept of death, and that death can happen suddenly and unexpectedly even to healthy infants and children, will be a lesson on the cruelty and unfairness of life – a lesson Christopher should not have to learn at such a young age.

I was relieved to read, at least according to this study, that creating rituals in celebration of the baby who died – sharing photographs and memorial keepsakes, participating in family traditions to honor birthdays and holidays – establishes a symbolic link between siblings and connects them in healthy ways. Surviving siblings who grow up celebrating the memory of their deceased baby brother or sister experience fewer negative consequences and feelings than those whose parents kept their grief for the baby private. Parents who try to shield their surviving children by never speaking of the baby who died ironically cause more trauma in the long term.

Death Of A Child In The Neonatal Intensive Care Unit: Long-term Consequences For Siblings
ScienceDaily (2009-04-06) — Little is known about the long-term effects of the death of a child in the neonatal intensive care unit on survivor siblings. These siblings may encounter unforeseen emotional difficulties and developmental consequences that can occur whether the siblings are born before or after the infant’s death. … > read full article