New Research helps prevent stillbirth – Radio Interview 24NOV17

turn to the very serious issue of stillbirth I was what they call a geriatric mother back in the day and certainly one of the things I was made aware of was that stillbirth was a possibility and it was much more a possibility as a geriatric mother that someone aged over 35 my two guests in the studio and fortunately have both had first-hand experience of stillbirth but they've gone on to do research and to help other mums adjoining me our associate professor Jane Worland midwife academic at university sa welcome Jane thanks for having me lovely to have you in here and someone who I've spoken to before Claire Ford the founder of still aware lovely to have you here Jane I might start with you because the research your co-author on one of these pieces of research and a couple of independent studies been released this week in the hope of dramatically reducing still births so just if you could tell us about the study that you've been involved with it's really about monitoring your child in utero isn't it yes so the big study that we've published this a couple of weeks ago now was from a case control study which is for almost the highest level evidence that you can get short of doing a randomized control trial which obviously you can't do for stillbirth because you can't randomize people to have a stupid so very strong evidence that says to us that not only do we need to be concerned about the baby who moves less but the baby who suddenly has a flurry of activity and also the baby who's moving weaker we also need to be concerned about babies who change in their passions so for example if you normally feel your baby moving at bedtime and you don't that's also something to be concerned about so really anything that the baby does that's different from what the baby normally does the mother needs to report to her maternity care provider so it really comes back to knowing your own body knowing your baby's own patterns and Zulu being attuned to those yes and having trust in your own view or your own intuition if things change absolutely is one of the problems that maybe women who have had a stillbirth have felt these things going on but haven't reported it mmm yes we think that that's likely to be the case one of the triggers for this particular study was that we had a big summit meeting in Minneapolis a number of years ago now and there are a lot of brief parents there and this study was actually generated by questions that they asked and one of the brief mums I remember very clearly said I remember very strongly that my baby had a sudden crazy time where the baby just went bananas is that any kind of concern do you think that other parents have felt it and interestingly even Claire felt that before Alfie died so it actually seems like it's perhaps a little bit more common than we have previously even thought had there been any information gathering done in hospitals where women have had a stillbirth about these types of things to actually gain information from the mother direct or are we retrospectively now trying to obtain that information we're gathering it from people who have experienced a stillbirth and also importantly for this study people who experienced a live birth so interestingly with this particular study we had women who were in the case group the stillbirth group saying my baby went crazy my baby went wild ballistic nuts bananas those sorts of words the controls only one of the 500 controls used words like that and she sounded like she was in the MS because she said my baby went crazy it concerned me I went to hospital they checked out the baby it wasn't well I ended up needing an emergency cesarean section the baby was born blue needed to be resuscitated and then the baby is fine now so that to us indicates that if the mother acts quickly when this happens that there may be a short window of opportunity for her to save her baby's life it's a big responsibility on a mother isn't it yeah but mothers have got responsibilities anyway yeah and that responsibility really starts from the moment that you can save we have responsibility for our toddlers you know if our toddlers aren't well we take them to the doctor if we feel that our BETT unborn baby is not well we should do the same thing yeah take ourselves and our baby and not be worried that we're going to be bothering somebody or GM not sure if you have any of those fears better to get it checked out there's a midwife myself I'm I would much rather reassure you a thousand times than have to say those awful words I'm sorry there's no heartbeat yeah I can imagine listeners right now who have had those words said to them and the trauma of that will stay with you forever this is a lifelong grief absolutely might bring Claire into the conversation Claire this is very high-level research but is it consistent with the things that you've been hearing through your work with still aware and from your own personal experience yeah absolutely and look we're so thankful that there is research to back all of this up but we've known for a really long time now that the mother is the the place to go in terms of understanding that baby so it's terrific now that we have solid evidence to back that up and now it's really time for the clinicians and the médicos to really get that – to say okay well I need you to come in and tell me about your baby because you have the best understanding of that little one inside you you're the only one who gets 24/7 with bub I only get a split split moment so it's really important that Mum speaks up but it's not just mum – it's the whole unit of care so that is partner husband mother whoever that birthing partner is – is to really help that mother feel empowered to stand up for her and her baby and absolutely we have many many women say to us that the baby not only decreased but rapidly increased they were scared they were worried but didn't grow in they waited until their next appointment or they waited till the next day they didn't know who to call at night and it's really it's really really sad but it's also incredibly disappointing that the system continues to fail people so I hope that this actually makes people stand up and go you know what we need to take action and really empower families to parent their babies whilst they're inside not just after they're born exactly it's information that should be given to all mothers I mean obviously the rate of stillbirth is high in geriatric mothers 35 and over but all mothers need to understand that they have got the best knowledge about their baby of anybody on the planet and if they have any fears they do need to act upon it absolutely and that's something that I didn't know and my child and so Alfie she her movements decreased then they rapidly increase to the point where I felt like she wanted to try and get out and I said this baby wants out and what did I say straight after to my husband was actually not a baby slows down before it's born that's what everyone's been feeding me so no she's not coming and then – I am following that time so that was 7 p.m. at night 2 a.m. was the last time I would ever feel her move so I had a time I had a moment and if I was given the tools that we give through still aware about monitoring a baby's movements reporting any change immediately and not waiting until someone says hey I can see you now or here's your appointment now fear would be here and so it's about making sure that everybody gets this information and making it a man Dacian you know isn't making it that every clinician has to give this information anyone who has any care of a pregnant woman has to give this information to them because without that empowerment they won't speak huh yeah and so you're left with not only the immense grief of not having that child in your life that you were anticipating but also you live for the sense of why didn't I do something or why didn't I know why didn't somebody tell me that's right so so Jane I've just bring it back to you then working as a midwife academic is this information getting across to practicing midwives to obstetricians in fact to GPS we were at the very first port of call often when a woman is pregnant I'm certainly doing my best I am involved in education of midwives Claire's doing her best we're still aware being involved in education of all kinds of maternity care providers in Australia across Australia but this kind of information is at the moment also I think needs to be brought into a program that maternity care providers are mandated to do once a year in much the same way as they mandated to look at the way that we electronically monitor the baby and make sure that they're up to date with that they also need to be up to date with these new advances you mentioned very briefly the other paper that yes I would like to get back to that because that is about induction yeah finding that for and for particular groups of women and they may not even have a gestational period up to 40 weeks but if you're in their danger zone and what are the danger signs for stillbirth there are certain predispositions aren't there yes there certainly are but gestation is is one of them and certainly for certain groups the Southeast Asian population we know tend to have a shorter gestation so they take into have a due time which is 38 weeks rather than 40 weeks but I think that we need to be really careful that we don't just say there's a blanket response to prevention of stillbirth I mean we should we should just say that that research was saying that perhaps if a person that had potential markers that could they mean mean that they are more predisposed to having a stillbirth that they should be induced a week or two before their due date that's what the research was saying wasn't it yes and I think that we as I said we do need to be careful about just saying well we'll introduce everybody and will prevent stillbirth we do need to be careful about looking at individuals risks so for example in your case if you were older but that might have been your only risk factor so they might not necessarily then say well we need to induce you but if you were older and they were monitoring your baby and your baby was small and you were saying hey the baby's moving a bit less those respecters are the ones that are then mounting up and should make any care provider say you know one plus one plus one plus one is adding up to a lot of risk factors now and perhaps we should consider inducing you my own personal experiences as a geriatric mother which nobody really likes to be cold but that's the term if you're over 35 was in fact that I had a placental placement meaning that I wasn't very as much in touch with my baby which I mentioned some women would have so it makes it more difficult to judge but definitely things did go a bit pear-shaped for me at the end and and I was over the Jew time and did have to be induced and I think that for me it was a lucky thing really interesting that you just mentioned where your placenta lie and where it lay so basically I was assuming that you're saying your placenta was at the front so I didn't really feel there kick so what's really interesting about that and that's actually also something that is fed to women and is also a myth in a in a sense to that and because your placenta sits at the front you won't feel the movements now the fact is you will still feel your baby moving within you within your own body so it's really important to get to know who and how that baby is regardless of where your placenta lies but it may not be as obviously moving so whatever that consistency is or whatever that normal pattern is regardless of where your placenta is should still remain the same and that not to worry if you need to call and also not to placate yourself and say oh well my placenta is at the front that's why the baby's bit cushioned and that's why it's not moving so much there's all these myths that we need to dispel to like a baby doesn't slow down before it's born doesn't matter where your placenta is for you to be able to feel it yourself it doesn't you know the fact is ten movements isn't what matters it's about what your baby is doing in there so it's really important to get to know your own individual baby report any changes immediately and act as a parent now because you have complete control of that of the of your pregnancy – you're part of that care unit and that means baby mum and care provider and if you remove one of those wedges that care unit is missing it's lacking so you are just as equally important as your obstetrician midwife doctor more important in a way yeah well I really admire the work that you're both doing Claire Ford founder of still aware which is out there putting this message to mum's which is fantastic associate professor Jane wall and a midwife academic at university si both of you bereaved parents Emma your loss Jane and Alfie Claire thank you for taking what were personal tragedies and helping other parents and would-be parents and

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