Dead Babies

By Jim McVeagh 22/11/2009

Stillbirths are traumatic. I am a seasoned provider of terminal care, so the dying process does not phase me, like it phases many of my colleagues. Even so, the death of a baby is horribly unpleasant and even more so when the baby is stillborn or dies soon after birth. All that expectation of happiness and joy crushed and replaced by grief. It is probably the worst part of medicine and certainly the worst thing that a mother can experience.

I find it mystifying, therefore, why people feel the need to misrepresent the facts when advocating for perinatal mortality research and funding. [Actual report here (PDF)]

With nearly two unborn (or very newly born) New Zealand babies dying every day, more money needs to be invested in keeping pregnant women and their babies healthy, a maternity expert says.

Cindy Farquhar, professor of obstetrics and gynaecology at the University of Auckland, says the number of babies who are stillborn or die within four weeks of birth is higher than New Zealand’s road toll, yet funding is minimal compared with the millions of dollars poured into road safety campaigns.

Now this is a silly comparison. It is true that more babies die in the perinatal and neonatal period than people who are killed on the road. This is indeed a tragedy. But the vast majority of these deaths are from unavoidable complications of the pregnancy or severe foetal abnormalities. These are factors that are not amenable to alteration by committee or government pronouncement. The vast majority of Neonatal deaths in the first 4 weeks, for instance, were extreme prematurity and congenital abnormalities, neither of which are medically remediable. Most of the recommendations in the report are not directly medical, focussing on social factors such as smoking and delayed registration with a midwife. These factors almost certainly need community intervention rather than government driven programs which have not been shown to be particularly useful, in general.

32 babies died from hypoxia (low oxygen) during birth and that is a worrying number, as it implies poor medical supervision of the birth process (but not all hypoxic birth deaths are due to poor obstetrics). This is certainly something that needs to be looked at, especially since a further 102 stillbirths fall into the category “unknown”. Anything that can be done to prevent this kind of medical disaster is worth doing. Perinatal deaths such as these should always be fully investigated, not so much as to attach “blame” but to establish what can be done differently, to avoid this outcome.

So, while I agree with the call for more funding and especially more research in this area, I fail to see the need for exaggeration. The possibility that 32 or more babies died because of poor childbirth techniques and protocols is alarming enough, without resorting to silly comparisons with road tolls. That kind of emotional blackmail tactic is likely to backfire as politicians are likely to react in a very negative fashion.


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