Washington Post Examines Lack Of Information About Stillbirths, Bill To Expand Data Collection

Main Category: Pregnancy / Obstetrics
Also Included In: Women's Health / Gynecology;  Pediatrics / Children's Health;  IT / Internet / E-mail
Article Date: 09 Jul 2009 - 3:00 PDT

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Centers for Disease Control and Prevention data show that stillbirth occurs in about one in every 160 pregnancies in the U.S., but physicians rarely warn pregnant women or their partners about the possibility, Washington Post staff writer Alan Goldenbach writes in an article discussing his experience when his wife's pregnancy ended in stillbirth. In the U.S., the clinical definition for stillbirth is the death of a fetus after 20 weeks' gestation or weighing 350 grams if the age is unknown.

There are about 26,000 stillbirths annually in the U.S., according to CDC. Goldenbach writes that this is "10 times the number of deaths attributed to sudden infant death syndrome, which has been identified as a key public health issue, and four times the incidence rate of Down syndrome, for which prenatal testing has become almost ritual." He continues that many doctors told him and his wife "that they don't see any point in discussing stillbirth, that it's a catch-all term for an event, and one that is frequently unexplained." Doctors contend that if they knew the causes or signs of stillbirth, they would warn patients or take preventive action, he adds. Noting that awareness of SIDS spurred research into preventive measures, Goldenbach writes that "[w]e can't know if improved technology or more stringent standards of monitoring can lower stillbirth rates unless we do the research."

Ruth Fretts, an assistant professor of obstetrics and gynecology at Harvard Medical School and chair of the scientific committee for the International Stillbirth Alliance, said, "It's a trade-off -- you are going to frighten a lot of people" by discussing stillbirths. According to Fretts' research, the leading cause of fetal death after 28 weeks' gestation is an unexplained source. Goldenbach writes, "Several doctors told us privately that many ob-gyns fear charges of malpractice following a stillbirth, leading them to avoid citing a cause of death."

Stillbirth Legislation in Development

Sen. Frank Lautenberg (D-N.J.) is drafting legislation similar to a stillbirth prevention bill that then-Sen. Barack Obama (D-Ill.) introduced in June 2008. According to sources familiar with the bill, it will be brought to the Senate floor before the August recess. The legislation will expand stillbirth registries already in operation in Iowa and metropolitan Atlanta. The bill's supporters hope to have as many as 12 states participating in the registry and installing a standard protocol for data collection after each stillbirth. Another provision would create a campaign to increase public awareness and strengthen grief support services, Goldenbach writes (Goldenbach, Washington Post, 7/6).

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