Twenty years ago this week my daughter Caroline was stillborn. Her birth and death cleaved my life into before and after. The trauma, grief, sorrow and pain debilitated me for a time. Our family has never been the same. There is always a daughter, a sister, a granddaughter who is missing.
Twenty years is about how long Australia has been keeping an accurate count of stillbirths. In that time the number has stayed exactly the same: six babies a day. In Australia, we lose approximately 2,200 babies every year to stillbirth. The rate of death from stillbirth is higher than the national road toll. Stillbirth is the No. 1 cause of death for infants.
For 20 years, Australia has paid almost no attention to this private tragedy that occurs on a significant scale. We did not speak of this personal grief that thousands of Australian families experience each year. We did not ask why it happens, or if we could prevent it. It’s not that we didn’t care. I suspect we kept silent about the tragic deaths of so many babies because it was so overwhelmingly sad. I can understand that – I would have preferred to never know this extraordinary grief.
Other countries have taken a different approach. The Netherlands, the UK, and New Zealand have made reducing stillbirth a priority and made significant progress, saving thousands of babies’ lives.
Last year, the Australian Senate Select Inquiry on Stillbirth developed the first national set of recommendations to drive down the rate of stillbirth in this country. This multi-party committee of Liberals, Labor and Greens handed down a unanimous report, recommending clear steps in the key areas of education, research and bereavement support.
Last week, the Andrews government in Victoria became the first in Australia to set a target to reduce stillbirth – a 20 per cent reduction by 2022. Key to its efforts is the Safer Baby program, based on work developed by the Stillbirth Centre for Research Excellence in Brisbane. The Senate report recommended this program be rolled out nationwide.
In the 20 years since I gave birth to Caroline, I have gone through guilt and grief, sorrow and depression, and often anger. What surprised me most when participating in the Senate inquiry last year was how much anger I felt listening to the heartbroken parents giving evidence. In 20 years we have hardly advanced in preventing stillbirth or in giving parents the support and help they need when it occurs.
There are things we know about preventing stillbirth we are simply not telling parents or clinicians – like the importance of sleeping on the side when pregnant or in how to monitor foetal movements. There are things we could know about stillbirth if we simply investigated stillbirths when they occurred, collected data better and made the information more readily available.
Victoria is leading the way on these measures. For example, better data collection and new clinical guidelines have already shown results. A few years ago, clinicians at Monash Health noticed that women from South East Asian background were having a higher rate of stillbirths at the end of a pregnancy that other women. By making changes to their clinical approach – such as adjusting the definition of “full-term” for these women and intervening earlier to deliver rather than just monitor a baby that might be at risk – Monash Health have in fact achieved an amazing result: no stillbirths in South East Asian women at term.
The Monash Health example shows that reducing stillbirth is not necessarily complicated or expensive. The researchers I speak to in Australia are confident that small changes in clinical care and education could reduce the rate of stillbirth in Australia by 30 per cent in just a few years.
In the 20 years since Caroline was born, Australia has lost some 44,000 children who were wanted and loved by their parents. These babies would have grown up and contributed to our nation as workers and as parents themselves one day. The loss of 44,000 people to our nation is no small matter. The fact that 44,000 families have known and suffered the loss of their baby is no small grief.
We can’t wait another 20 years to start. We can prevent stillbirth and we can save babies’ lives. The only thing we need now is the national determination and leadership to do so. Labor will work with the Morrison government on this effort, but it is now up to Minister Hunt to take the next step. Responding to the Senate inquiry would be a very good place to start.
Kristina Keneally is a Labor senator for NSW.
This story originally appeared in the Sydney Morning Herald on 19 June 2019.