Hi all,

In the news today the lead story was all about how our baby and/or mother death statistics in NZ have not been well
collated so at the moment they do not even know where the problems are in order to go about improving things.

I am amazed at how much I want to know " how often babies die" since Amelie died. It kind of helps me. Anyway, it has been really hard to get accurate stats even from the health department website and each person I talk to has different bits of the puzzle and no one seems to have the whole picture.

Anyway I wondered if any of you have any useful facts or figures to help build the picture until the government gets around to it!?

One statistic I have first hand from a SANDS organiser in Welllington is that 350 babies over 18 weeks of age (and weighing at least 400gms) die at Wellington Hospital each year.

That is a huge number of babies and a huge loss to the mums and dads in just one city with a small population. Apparently in outer lying areas where the hospitals are less well equiped the death rate is even higher.

I also wondered if any of you also have been trying to find out some stats to help you cope with your loss?

Thanks,
melanie

Melanie

I'm not sure if this will help you but Wellington Hospital is one of the main "infant-care" centres in New Zealand and has intake from all over the lower north island and upper south island when a baby is idenitified as high-risk. Doesn't really make the 350 deaths any better but just wanted to let you know. Wellington Hospital also has a very good reputation for neonatal care although I have seen recent news articles that say they are understaffed at the moment. When will the government put more money into solving some of these problems?

Hope you find some answers soon.

Claire

Thanks Claire.
Yes I had suggested similiar to the SANDS woman with images of helicopters flying in ill babies.She agreed but implied that alot of deaths occur in the less well equiped areas. Again I do not have the stats but she implied the rates may be even higher because of the less advanced emergency care.

It would be good to know how many of the babies who die have a cause of death or not. My understanding is that around 70% of babies who die at full term they can find no reason. That would mean I guess that the wonderful staff at Wellington neonates would not have had a chance to try to save those babies.

I am wondering if a lot of babies are dying near fullterm, maybe pg women should all have a scan at 38/39/40 weeks - if it could save even one baby's life a year would it not be worth it?

Unfortunately in some cases babies are lost in an instant e.g cord blockage, cord compression and I'm pretty sure that couldn't be diagnosed with a scan unless it occured at the same time. But yes, you are right, if the scanning process could save even one baby's life it would be worth it (a bit like the Vitamin K injections most newborns get).

I was just lurking on the February MTB board and one of those mums has been diagnosed with a very high risk pg. She was initially put into hospital for the week leading up to her c-section but has since been sent home. She is never allowed to be alone though in case of an emergency and must call an ambulance if she goes into labour or her waters break. Scary stuff - to be honest I think I would rather be in hospital if it was that touch and go.

Interesting discussion - if only there was more money for research

Yes Claire I agree more money for research to even formulate the right questions would be a really good start.

I was totally 'low risk' so losing Amelie was a terrible shock. I've been wishing I had had something wrong with me so I would have been scanned in late pregnancy and they MAY have picked something up. It is really so hard to accept her death when there was nothing wrong with her. It is hard to understand why she suddenly suffered a lack of 02 in the labour. Her placenta was all attached and looked okay.

I sure hope everything goes well for that Feb MTB.

Whooops getting off the topic of stats!!

Just FYI in case anyone finds this interesting:

"There are neonatal units attached to National Women’s and Middlemore hospitals in Auckland, and Waikato, Wellington, Christchurch and Dunedin Hospitals. If you live in an area where there is not a neonatal unit, you and your baby may need to be transported to a neonatal unit by ambulance or by air."

From an article I wrote on prematurity for OhBaby! I'm not sure what the policies are here on linking but I'm happy to post a link to the article if anyone wants a looky.

I just find it pretty sad that in a country the size of NZ we only have 6 Neonate units (North Shore has recently opened a SCBU but can't provide ventilation) and that of that 6, 3 are in the upper North Island. Doesn't bode too well if you live elsewhere and your newborn needs special care.

Like you other ladies have said, many precious babies are lost in a split second and no amount of planning or aftercare could alter the outcome, but there are also a percentage (and you're right - even if it's only one baby it's worth it) that might have been saved if the facilities were available to diagnose and address complications earlier.

And another random stat - 15% of confirmed pregnancies end in miscarriage. As many as 25% of all pregnancies may end in m/c tho as some m/c occur prior to a woman finding out she is pregnant. Miscarriage is more common in first pregnancies and following fertility problems/treatment. A woman who has had 1 m/c has an 80% chance of a successful subsequent pregnancy, as does a woman who has had 2 m/c. With the 3rd and following m/c the chances drop, but with monitoring and treatment nearly all women will go on to have a live birth. (From "Getting Pregnant" by Prof Robert Jansen.

I guess that I fit into the few who knows what their baby passed away from, but again it was all in a moment and no one saw it coming and by the time it did it was too late.
It is a bittersweet when I go up to visit Eden and you look around and see how many babies there are there and talking to the parents and as you have said most have no idea what has caused it, and most have been term stillborns, it does make you wish they would scan later in the pregnancy, if it only be for one life, I agree it is well worth it.

On the talk of NICU and all, when Nikita was in NICU we were approached and told that it was possible that they would have to fly us to Melbourne as all NZ units were full.
With Eden they rang around trying to get me into either waikato or Dunedin cause Akld and Middlemore were full, But lucky for us as Eden was delivered in the afternoon they had just discharged 2 babies.

For a country at the front of Medicine we have a long way to go.

Did anyone hear the National radio insight programme this morning after the 8am news about the maternity situation in NZ?

It was hard to listen to at times but I do want to know. I felt the midwives attitude appeared to be a bit light hearted- they of course like to look at all the babies they are born well rather than the ones who do not make it.

The statistic stated was that there are 600 perinatal deaths per year in NZ. Perinatal means in labour or just after labour I think. That is like two fullterm a day. Where are all these women???

Are there any women out there who have lost their baby, who are reading this board without posting?

United we are so much stronger. I hope together we can help prevent as many babies dying in the future.

Thanks for taking the time to read this,
Melanie


PS: I realised this past week that I am furious that Amelie died a preventable death. If the risks of going overdue had been explained to us and we had been offered a scan as part of a management plan then she may well be alive today. I am going to try by whatever means I can to ensure that LMC's HAVE to inform pg women of the risks (informed consent) and offer a scan on the due date.
I am thinking of getting some women together and talking to the Coroner. Has anyone got political experience or feel they would like to be involved/help?

Hi Melanie - Yes what terrible statistics!!!

I'm not sure how much I can help but my support is there.

I have decided to talk to my mw about an extra scan close to my due date (like maybe 37 weeks) just because of this discussion. I'm not sure whether it would necessarily pick up a problem but hey what have I got to lose and if it did alert us to something, wouldn't it be the best decision I ever made. My next appointment with my mw is Tuesday week (the 14th) and we are booked in to talk about past experiences and birth plans so I'll let you know what she says.

Oh and BTW - I know Twitch from the EBB and your (and her) mw birthed my second son Noah. I know this is a very personal question but do you think she could have personally done more for you in terms of information or is the whole system flawed - or perhaps both?!?

Thinking of you. Feel free to be furious here. It sounds like it is more than valid.

Claire

Hi Deanie,

Thanks for asking about my m/w yes I trusted her completely as you do with your LMC. As you know lso she is intelligent and empathetic and seems thorough.

However we were not informed of any of the risks of going overdue and I wish they had been explained by our LMC and we had been offered a scan on our due date and a week later to check on our baby. I knew she was not so into the medical model but we had discussed that 'healthy baby and mum' was the top priority.

The day before Amelie was born she palpated my tummy and said there was plenty of fluid there. However when they did the scan after she died early the next morning they said there was hardly any fluid (and my waters were still intact). So yes I am really furious that not more was offered to monitor and take care of our precious baby. If only I could turn back the clock...I think it is very wise of you to have a 37 week scan.

Apparently they do not tell pg women of the risks because they do not wish to alarm them!! (I'd say your perfect baby suddenly dying is a hell of a lot more alarming!)

I am so MAD!

Oh and from the NZ Herald today apparently 'The only safety obligation imposed on the practitioner.... is to ensure the cultural safety of the woman'. Health commisioner Ron Paterson.

I would say the system needs to be changed so that the practitioner has to obtain informed consent from the pg woman for going overdue - ie explain the risks, ensure the parents understand and then do EVERYTHING possible to ensue a positive outcome (ie live baby and mum).

What does everyone think of that as a plan?

Melanie - I would be happy to help in whatever way I can. I did an undergrad degree in Communications with some politics stuff, and I'd love to write an article addressing your concerns if you think that would help. I know that I can publish it on OHBaby! (I am the site editor), but it might also be a useful way of collating info for the coroner etc. I think now is a great time for it as it is so topical in the news.

Re: the whole going overdue thing - I never knew that there were risks involved with going overdue until I started researching pregnancy complications for OhBaby! From what I have learnt (that the placenta starts to deteriorate rapidly after 40 weeks) I will be insisting on a pre/full term induction next time round (may not be an issue as I went into spontaneous preterm labour with Maya so that could happen again), and scans after 37 weeks to ensure the placenta is functioning well.

That said, for many years women have been allowed to go as far as 14 days over nd have still given birth to healthy babies. As far as I'm concerned tho, if there is any way to lower the risk to Mum and Baby, even if only by a fraction of a %, then it is worth it.

Let me know if you are interested in having me put something together and we can juggle around some ideas on what to include.

Emma

Thanks so much for your offer Emma.

I am off to oz at 6am tomorow for post grad study so thoughts will be percolating in there.

I'm back 13th of Feb and will check in again then. It feels good to get some cogs turning and eventually hopefully the right changes will be made to safeguard more babies and mums...

Cheers,
melanie

Hi Melanie

I had my 2nd mw appt today and spoke to her about what we had discussed on here. She was very interested and is happy to support a MTB in whatever they need but doesn't really recommend late pg scans because she feels that they offer a false sense of security. She was well aware of the tragedies that do occur and she was very sympathetic and caring but still feels that it would be rare to pick up a problem on a scan as most late losses happen in an instance (as we already know). She did say that her top priority was having a safe and healthy mum and bubs at the end of the day and she would do absolutely everything in her power to make that happen. I did feel very reassured and will see how I feel later on in terms of a scan.

Oh and she also said that she doesn't personally believe in leaving pgs much past their EDDs because of the potential risks which is interesting because most people say 10 days post EDD before induction don't they?

Anyway, just thought I would give you an update.

Claire

P.S Hope you had a great break away - was the course good?