Preventing the tragedy of stillbirth by Alex
In the UK, one in 220 babies are stillborn. Dr Alex Heazell, Clinical Director of the Tommy’s Stillbirth Research Centre at The University of Manchester, is changing that with the help of donor support.
Despite advances in maternity care, stillbirth remains a significant complication of pregnancy, which has a devastating effect on parents and their families.
Ten babies are stillborn every day in the UK, making it 15 times more common than cot-death. The stark reality of this is that over 3,200 families leave hospital every year without their precious baby.
Stillbirth is made even more difficult for families to understand and come to terms with because around 30% of cases occur late in pregnancy with no known abnormalities, when delivery would have likely led to the birth of a healthy baby.
There has been little reduction in stillbirth rates over the past 20 years. Yet, despite these alarming figures, it remains a majorly under-funded area of research.
Misconceptions around stillbirth
There is quite a taboo about talking to mums about stillbirth when they’re pregnant, as if by somehow talking about it we’re opening up the possibility that this might happen to them. And I think the other misconception is that it’s just one of those things and there isn’t anything we can do about it.
Stillbirth has had a relatively low focus of research. There are about 8,200 papers published about stillbirth, whereas if you compare it to other pregnancy complications, preeclampsia has about 30,000 publications and preterm birth, which is responsible for a lot of neonatal deaths, has 25,000 publications.
We’re one of the only dedicated stillbirth research centres in the world, and I think that’s really telling. We need to make this a prime focus to reduce the number of babies that die.
Manchester has a very strong history in pregnancy research. A lot of pregnancy complications result from something going wrong with the placenta and there’s been placental research in Manchester for over 50 years. We’ve got a real history and a great group of knowledgeable people.
The other great thing about doing this sort of research in Manchester is firstly, we’ve got a really diverse population. That means that if we can make something work in Greater Manchester, then we can roll that out with confidence over the rest of the country, much more so than if we did it somewhere with a very similar population.
Our research so far
In 31% of stillbirth cases, a mother will report that their baby had become less active in the days before their baby died.
We have shown on our laboratory that the placenta in women who come to hospital with a reduction in baby’s movements is smaller, abnormally shaped and more damaged than those with normal movements.
We believe that a reduction in babies’ movements is a sign that they are receiving less nutrients and oxygen from their mother because the placenta is working less effectively.
When a woman comes to hospital because their baby’s movements have slowed, we need to performing specialised tests. By doing so we can identify more women whose babies are most at risk of stillbirth, allowing us to deliver them before they die.
This research has since led to a major nationwide study to assess whether giving women information about reduced fetal movement and performing these tests can help prevent stillbirths.
We have set an ambitious target to reduce preventable stillbirths by 50% across Greater Manchester by 2020. Following our initial study, we have already seen a reduction of 19% in the stillbirth rate at Saint Mary’s Hospital, where our studies take place.
The next chapter
Now, we want to apply our thinking and what we have learnt so far about reduced foetal movement to mothers who experience the opposite symptom, that of increased fetal movement. Thanks to support from donors, this study is going ahead.
The impact of donations
Charitable donations are extremely important in stillbirth research. I think stillbirth is still seen by the national funding bodies as something that’s not particularly fundable. We have to win that argument and we have to win that debate, and we’re only going to do that with data and numbers. And this is what the fundraising charities have enabled us to do.
I think that the work we’ve done so far has shown that even comparatively small donations enable us to start projects off that otherwise wouldn’t have started.
For me, it’s a bit like planting a very small seed that you can watch grow. Sometimes you have to plant several seeds to get one really strong tree, and you never know which of those it’s going to be. But to any potential donors, I would say this is an opportunity to make a huge difference in an area that really needs investment.
Watch our short documentary and see what we’re doing to prevent the heartbreak of stillbirth.
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