Reducing preventable stillbirths: The opportunity for midwives

Caroline Homer and Vicki Flenady

In January 2016, The Lancet released their second series on stillbirth, the theme of which was ‘Ending Preventable Stillbirth’. The five-paper series reported on the present state of stillbirths, highlights missed opportunities, and identifies actions for accelerated progress to end preventable stillbirths and reach 2030 maternal, neonatal, and child survival targets.

The Series showed that most stillbirths are preventable with health system improvements. High quality antenatal and intrapartum care is critical. Midwives have a key and significant role to play in the provision of this care. In particular, midwives deliver the antenatal package of care that includes prevention and management of maternal infections, including malaria and syphilis, the care of women with hypertension and diabetes, detection and management of fetal growth restriction and the provision of respectful care. Preventative care during labour means careful and appropriate fetal surveillance and, if needed, support for assisted vaginal birth and caesarean section, access to post-term labour induction if appropriate in the health system context, and again, respectful care

The aim of this presentation will be to present an overview of The Lancet’s Series on Stillbirths (2016) with a special focus on the role of midwives in prevention and in the support of families. This will include midwives in high, middle and low income contexts.

The presentation will also discuss the impact of stillbirth on midwives including their own feelings of stress, grief, trauma and sadness, fear of ramifications and litigation or disciplinary action and their own concerns around blame and guilt. Many of us have also grown up in an era where it was not considered professional to show your feelings in front of patients. Expressing sadness, sorrow or even tears is not allowed for many midwives in different countries. This has often meant that grief and sadness is suppressed and hidden and midwives were expected to just ‘get over it’ and move on. This is not acceptable or helpful and new ways of working through this grief needs to be found to hear the voices of women, their partners and families and the health workers.

 

This presentation will therefore also talk about the need for midwives to have education about how to care for women, their partners and families – as student midwives, nurses and doctors. Midwives need to have systems in place to support themselves and one another.

 

We look forward to the opportunity to share this important Stillbirth Series with midwives from all over the world.