Ruqayyah Snyder
In Australia, around six babies are stillborn each day, affecting 2,000 families annually. This rate has remained unchanged for two decades, with the Australian Institute of Health and Welfare (AIHW) reporting that the overall stillbirth rate has stayed between 6.7 and 7.7 per 1,000 births between 2003 and 2021. The Australian government has since launched the National Stillbirth Action and Implementation Plan, aiming to reduce stillbirth rates by 20% by December 2025.
| Characteristics | Values |
|---|---|
| Number of stillbirths per day | 6 |
| Number of affected families per year | 2,000+ |
| Proportion of stillbirths with unknown causes | 1 in 3 |
| Overall stillbirth rate | 6.7 to 7.7 per 1,000 births |
| Time period for overall stillbirth rate | 2003 to 2021 |
| Federal government target reduction in stillbirths | 20% |
| Deadline for target reduction | December 2025 |
| Proportion of preventable stillbirths | 30% |
| Risk of stillbirth for Aboriginal and Torres Strait Islander women | Higher than average |
| Risk factor | Smoking during pregnancy |
| Proportion of pregnant women who smoke | 1 in 10 |
| Sleep position risk factor | Sleeping on the back |
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What You'll Learn
Stillbirth prevention strategies
In Australia, stillbirth affects 6 families every day, which equates to more than 2,000 babies each year. The rate of stillbirth has remained between 6.7 and 7.7 per 1,000 births between 2003 and 2021, when the most recent data was recorded. This rate has remained effectively unchanged for two decades.
To address this issue, the Australian government has developed the National Stillbirth Action and Implementation Plan, which aims to reduce the number of stillbirths in Australia by 20% by December 2025. This plan includes the Safer Baby Bundle (SBB), which provides information and resources to both maternity care providers and women to reduce the risk of stillbirth. Here are some specific strategies that are being implemented as part of this plan to prevent stillbirth:
- Public awareness campaigns: One focus of public awareness campaigns is educating women about the importance of sleep position during pregnancy. Research has shown that women who sleep on their backs after 28 weeks of pregnancy have an increased risk of stillbirth. Therefore, it is recommended that pregnant women settle to sleep on their sides.
- Improved detection and management of fetal growth restriction: Fetal growth restriction, when the baby isn't growing well, is a strong marker of potential problems, including stillbirth. However, Australian midwives and doctors often fail to detect this condition, only identifying around one-third of cases. Improving detection rates and providing careful management can increase the chances of a healthy birth.
- Addressing socioeconomic and ethnic inequalities: Socioeconomic and ethnic inequalities are responsible for a substantial proportion of stillbirths. Prevention strategies should target the entire population as well as specific minority ethnic groups at high risk of adverse pregnancy outcomes, addressing risk factors and wider health determinants.
- Reducing smoking during pregnancy: Smoking during pregnancy is strongly associated with stillbirth and other serious problems. In Australia, about 1 in 10 pregnant women smoke, and quitting can significantly reduce the risk of stillbirth and improve the health of both mother and child.
- Improved antenatal care: Regular antenatal appointments allow midwives and doctors to track the baby's growth and development, identify any concerns, and respond to them as necessary. This can help address issues such as infection, maternal health, bleeding, premature labour, and abnormalities with the developing baby, which are all major causes of stillbirth.
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Stillbirth causes and risk factors
In Australia, stillbirth affects more than 2,000 families each year, with one in every 135 pregnancies that reach 20 weeks ending with a stillborn child. The rate has remained between 6.7 and 7.7 per 1,000 births between 2003 and 2021, when the most recent data was recorded.
For one in three stillbirths, the cause is unknown. However, in Australia, the major causes of stillbirth are infection, the health of the mother, bleeding, premature labour that cannot be stopped, or an abnormality with the developing baby.
Infection
Infections from viruses, parasites, bacteria, or other pathogens (germs) cause up to 50% of stillbirths in developing countries and up to 25% in developed countries. Bacterial infections, such as group B streptococcus, E. coli, klebsiella, and enterococcus, can travel from the vagina into the womb (uterus). Other infections that can cause stillbirths include parvovirus B19, coxsackie virus B, cytomegalovirus, herpes simplex, listeriosis, and leptospirosis.
Maternal Health
Maternal health conditions that increase the risk of stillbirth include diabetes, high blood pressure, blood clotting disorders, thyroid disorders, lupus, and obesity (BMI above 30). Age also plays a factor, with stillbirth rates higher for teenagers and those 35 or older. Smoking during pregnancy increases the risk of stillbirth, as well as premature birth, Sudden Unexplained Death in Infancy (SUDI), low birth weight, and breathing problems.
Premature Labour and Abnormalities
Premature labour that cannot be stopped is a cause of stillbirth, as well as abnormalities with the developing baby. Problems with the placenta, such as placental abruption and pre-eclampsia, can contribute to stillbirth. Additionally, issues with the umbilical cord, such as cord prolapse or entanglement, can also lead to stillbirth.
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Stillbirth rates in Australia
Stillbirth is defined as the death of a baby after 20 weeks of pregnancy and before or during birth. In Australia, stillbirth affects 2000 families each year, with six babies stillborn every day, or one in every 135 pregnancies that reach 20 weeks. This rate has remained between 6.7 and 7.7 per 1000 births between 2003 and 2021, when the most recent data was recorded.
There are several factors that increase the risk of stillbirth. Smoking during pregnancy increases the risk of stillbirth, and in Australia, about one in ten pregnant women smoke. Other risk factors include infection, the mother's health, bleeding, premature labour, and abnormalities in the baby's development. Additionally, certain disadvantaged groups, including Aboriginal and Torres Strait Islander women, face a higher risk of stillbirth.
To address this issue, Australia has implemented the Safer Baby Bundle, which provides information and guidance to maternity care providers and women to reduce the risk of stillbirth. The National Stillbirth Action and Implementation Plan was also launched in 2020, aiming to reduce stillbirth rates by 20% by December 2025.
Despite these efforts, experts argue that outdated attitudes and delays in publishing stillbirth data are hindering progress in reducing stillbirth rates. According to the Centre of Research Excellence in Stillbirth, "sub-standard care" contributes to about half of stillbirths, with up to 30% considered preventable. Success in other developed countries, such as Scotland and New Zealand, highlights the potential for significant reductions in stillbirth rates through regular data collection, publishing, and targeted interventions.
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Support for families affected by stillbirth
Stillbirth is a devastating event that affects thousands of Australian families every year. While the Australian government is working to reduce the rate of stillbirths, the tragedy continues to occur, leaving families in need of support. Here are some ways to provide support for families affected by stillbirth:
Offer respectful and supportive bereavement care: The Australian government has recognised the importance of providing respectful and supportive care for families experiencing stillbirth. This includes postnatal care, spending time with the baby, inviting loved ones to meet the baby, and organising a funeral or ceremony to honour the child.
Educate on risk factors and prevention: Organisations like the Stillbirth Foundation Australia and the Safer Baby Collaborative provide resources and information to help families understand and manage risk factors for stillbirth. This includes guidance on quitting smoking during pregnancy, sleeping positions, and baby's movements.
Provide emotional support and resources: Various support services are available for families affected by stillbirth, such as Red Nose, Sands Australia, and Bears of Hope. These organisations offer peer-to-peer support, 24/7 support lines, and resources to help families cope with grief and loss. Books, podcasts, and videos specifically created for bereaved parents can also be helpful in processing their loss.
Improve data collection and research: Experts have noted that delays in publishing stillbirth data and outdated attitudes are hindering progress in reducing stillbirth rates. By improving data collection and sharing, Australia can learn from successful initiatives in other developed countries and develop more effective prevention strategies.
Increase support for autopsies and investigations: The Australian government is funding initiatives to support state and territory governments in conducting more stillbirth autopsies and investigations. This can help identify risk factors, causes, and potential prevention strategies, contributing to a better understanding of stillbirth and improved support for affected families.
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National plans to reduce stillbirth rates
In Australia, 6 babies are stillborn every day, affecting over 2,000 families annually. The rate of stillbirth has remained between 6.7 and 7.7 per 1,000 births between 2003 and 2021, when the most recent data was recorded.
The National Stillbirth Action and Implementation Plan is the first national plan to address stillbirth in Australia. The plan was developed in response to a 2018 Senate inquiry which examined the lack of movement on Australia's stillbirth rate. The federal government has set a target to reduce the number of stillbirths by 20% by December 2025.
The plan includes short, medium, and long-term actions to reduce stillbirth rates and improve bereavement services. It funds various initiatives to support its goals, including:
- A new clinical care standard and updated guidelines for health professionals.
- Support for state and territory governments to increase stillbirth autopsies and investigations.
- Research into activities to prevent stillbirth through education and awareness.
The Safer Baby Bundle is another initiative that provides information to maternity care providers and women to reduce the risk of stillbirth. It includes guidance for health professionals and resources for women, such as recommending that pregnant women sleep on their side.
Maternity services like The Royal Women's Hospital are also working together as part of the Safer Baby Collaborative to reduce stillbirth rates. By sharing knowledge, they can help women understand and manage the risk factors for stillbirth.
While the National Stillbirth Action and Implementation Plan is a step towards reducing stillbirth rates in Australia, there are concerns about outdated attitudes and data delays hindering progress.
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Frequently asked questions
In Australia, 6 babies are stillborn each day, affecting over 2,000 families a year. That means 1 in every 135 pregnancies that reach 20 weeks will end with a stillborn child.
The Australian government has committed to reducing the rate of stillbirth and launched the National Stillbirth Action and Implementation Plan in 2020, aiming to reduce the number of stillbirths by 20% by December 2025. The Safer Baby Bundle provides information to maternity care providers and women to reduce the risk of stillbirth.
In Australia, the major causes of stillbirth are infection, the health of the mother, bleeding, premature labour that cannot be stopped, and abnormalities with the developing baby. Smoking during pregnancy is also one of the main causes of stillbirth, increasing the risk of not just stillbirth but also premature birth and low birth weight.
