Hanami Prints Blog: Learning to Live Without Our Children » Medical Resources

Number of stillbirths a ‘national tragedy’, says charity – Times Online

hanamipapa — Wed, 18 Nov 2009 18:37:26 +0000

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.”

Pressure on understaffed neonatal and maternity units and a lack of funding for research into stillbirth is contributing to the avoidable deaths of almost 500 babies a year, according to researchers.

In a report to be presented to the Scottish Parliament today, Sands, the stillbirth and neonatal death charity, claims that the lives of many babies could be saved by improved services and increased funding for research.

The charity says that despite the figure of 325 babies stillborn in Scotland in 2008 — one of the highest per capita in Europe — there is currently no research into understanding stillbirth issues underway, a situation that it described as a “national tragedy”.

The number of babies stillborn in Scotland is equal to four times the overall deaths from MRSA, twice the number of adults who are killed in car accidents and ten times the number of cot deaths.

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Number of stillbirths has fallen sharply

Sands has called on the Scottish government to ensure that stillbirths and neonatal deaths are recognised as a major health issue and addressed as a matter of urgency and priority.

Neal Long, chief executive of Sands, said: “Almost 500 babies dying every year in Scotland is a national tragedy. For too long these deaths have been ignored and yet here is compelling evidence to suggest that many babies’ lives could be saved with improved delivery of maternity services and increased funding for research.”

The report, Saving Babies’ Lives, reveals that Scotland has one of the highest perinatal mortality rates in Europe — that is, babies who are stillborn or die within the first seven days of life. Mortality is highest in urban areas with the worst social deprivation and poorest general health indicators.

The stillbirth rate is 1 in every 200 babies born in Scotland, a figure which has not changed significantly since the 1980s.

Over half of all stillbirths are unexplained, the majority of unexplained deaths occurring in low-risk pregnancies. The campaigners want midwifery and obstetric training to focus more attention on the possibility that things can go wrong in pregnancy and how to recognise signs of risk and minimise those risks.

The report provides evidence that although per capita funding of maternity services in Scotland is comparably better than for England and Wales, there are still staffing pressures in maternity units and antenatal clinics.

“There is increasing evidence that many deaths related to events in labour are potentially avoidable,” it states. “Quality Improvement Scotland’s recent audit of intrapartum deaths (babies dying during labour) revealed alarming failures of care: in 44 per cent of cases where the baby died there was evidence of ‘major sub-optimal care’, which may have contributed to the death.”

Of the 53,000 babies born in Scotland every year, around 8,000 — one in seven — are admitted to neonatal units. Scotland’s premature birth rate is higher than in England and Wales and is increasing. Yet while the pressure on units is increasing, Scottish neonatal units continue to be understaffed and overstretched resulting in unnecessary transfers of babies and the closure of units to new admissions.

Babies in Scotland, the report claims, are not guaranteed one-to-one nursing care in intensive care units and says Health Boards must commit to a long-term recruitment and training strategy for the whole neonatal workforce to achieve minimum standards of care for babies.

There is also failure to accurately identify and understand risk factors for stillbirth, which include obesity, smoking, social deprivation, teenage pregnancies and older mothers. All these factors are high and rising in Scotland.

Gillian Smith, of the Royal College of Midwives, said: “The RCM in Scotland welcomes this report and recognises that more work and research has to be carried out around the loss of these babies.

“We share concerns around the reorganisation of maternity services and would support Sands in their request to make sure that during these reorganisations we do not lose the valuable input not just from midwives who specialise in providing support to parents and families at this time but also for onsite facilities which help families come together and start the grieving process.”

Case study

Not once, but twice Marion Currie has experienced the devastation of losing a baby at an advanced stage of pregnancy. Her daughter, Lesley, was stillborn in 2002, and her son, John, in 2006.

Both pregnancies had apparently been proceeeding quite normally and she had no reason to worry. With better knowledge, she believes, it might have been possible to anticipate problems and her babies might have lived.

“With my son, it was believed to be placenta failure. With my daughter, the cause was unknown, but perhaps in both instances if simple tests had been available, and there was more knowledge, it might have been different, it’s difficult to say,” said Ms Currie, 47, from Musselburgh, who edits a newsletter for the charity Sands. She has two other healthy children aged 14 and 4.

“If you could just identify which pregnancies are high risk, but appear to be low risk, then I’m sure babies’ lives could be saved. We need more research.

“There is an expression that says a new mother is born with every child. When the child is born, the mother is born. When the child is lost, that mother is left. I have two living children but I am very much aware that two children are missing from my life.

“No children are interchangeable or replaceable and every child is an individual. There are Lesley and John-shaped holes that will never be filled. And of course life goes on, you have to care and nurture your living children, but the holes remain. ”

via timesonline.co.uk

Posted via web from hanamiprints’s posterous

Separately but Respectfully

HanamiMama — Thu, 28 May 2009 21:20:22 +0000

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.

Hospital delivery safer for babies than home birth

Hospital delivery safer for babies than home birth

HanamiMama — Wed, 13 May 2009 16:15:24 +0000

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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No Cost, Noninvasive Test Could Save Infant Lives

No Cost, Noninvasive Test Could Save Infant Lives

HanamiMama — Mon, 11 May 2009 17:39:06 +0000

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

Long-Term Consequences of The Death of An Infant on Surviving Siblings

HanamiMama — Thu, 30 Apr 2009 16:32:56 +0000

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