Planning for pregnancy after experiencing a stillbirth is extremely frightening and challenging for couples. Stillbirth is the death of a baby before birth, or during birth and after 24 weeks of pregnancy. Couples struggle to cope with their grief, and recover physically and mentally. The taboo of a stillbirth makes it harder to confide in others and seek help. Bereavement counselling services are rare in our societies, as people refrain from discussions involving stillbirths.
Prevention of Stillbirths
Dr Nuzhat Aziz, who has been working on prevention of stillbirths for the past 20 years, and is currently the Vice President of Stillbirth Society of India, elaborates.
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In this scenario, planning for pregnancy and embarking on a journey again appears daunting, for 50% of stillbirths are unexplained, where no reason is given to explain why they lost their baby. Evidence suggests that pregnancy can be planned again, when a woman feels she is physically and mentally fit.
A specialised clinic helps ensure focused care and monitoring for women during such pregnancies. The follow up of these women includes detailed history, review of her past record, screening for specific medical disorders, evidence of foetal growth restrictions or foetal / genetic abnormalities. The pregnancy requires meticulous follow up with serial scans for foetal growth problems. Many stillbirths result from not identifying the decrease in fetal growth velocity in the womb. Customised centiles charts (Perinatal Institute, Birmingham) help monitor the baby’s growth chart, specific to the mother’s ethnicity, height, and weight. The specialised clinics are well appreciated for the emotional support offered by a familiar team at every visit. Parents have anxiety and fear right until their next baby is born, and in their arms. Hence, it is imperative that the delivery must be timed / planned after discussions with the couple.
All avoidable stillbirths must be prevented. India has the maximum number of stillbirths worldwide (13/1000 births when compared to 4 or 5/1000 births in developed countries), hinting at a scope of prevention. A mother can never forget her stillborn baby, and may remain traumatised and grieve quietly throughout her lifetime. While medical experts can step in and do as much as possible, it is also essential for friends and family to rally around couples who have had a stillborn baby, and become their emotional support system, so that they feel less alone and know that there’s always someone they can reach out to.
A dedicated clinic has been established for such women on Friday afternoons, 1-3 p.m. at Apollo Cradle Jubilee Hills.
MBBS, DGO, DNB
Senior Consultant – Obstetrics
Apollo Cradle & Children’s Hospital, Jubilee Hills, Hyderabad
For Appointment, Call 9958295296