Out of Sight? 

29 weeks pregnant 

As I walked up to the hospital today, I noticed a heavily pregnant woman sat outside smoking a cigarette. I was taken aback, even though I know that many people choose to smoke during pregnancy, I just find it so hard to comprehend how anyone could take any kind of risk with their baby’s well being. These days the risks of smoking during pregnancy are well documented, so the fact that anyone could knowingly gamble with their baby’s wellbeing is very hard for me to conceive.

Risk is a verb that I have tried to totally eradicate from my pregnancy world. In my pregnancy world I count and monitor every single kick and movement and I meticulously track and audit my weight, obsessing over the slightest of changes. In my pregnancy world I hold my breath at petrol stations and whilst walking past smokers or behind car exhaust fumes. In my pregnancy world I don’t dare sit in the bathtub or outside in the sun for too long in case I get too hot. I analyse every single product before it passes my lips or goes anywhere near to my skin. I run to the doctor with every single ache, pain, twinge, rash or change in any of my bodily functions and I spend hours online analysing every single pregnancy symptom I get. In my pregnancy world I fret about over exerting myself, getting too stressed or emotional, getting too warm, getting too cold, lifting virtually anything. I fret about illness and avoid people who are sick or who have recently been sick. I wash my hands at least twenty-five times a day. 

Of course I know that many of these behaviours are excessive and paranoid but they are done through care and caution and help me feel that I’m doing all I can to protect this baby. I suppose it’s done from a desire to control a situation in which I realistically have very little control. I am driven by a mix of the guilt I feel that maybe I didn’t do enough to protect Nieve, and the fear I feel that I might lose another baby. 

Today my consultant showed me Sprocket’s growth chart and it was reassuring to see that he is measuring perfectly for his gestation. I asked him to show me where Nieve would measure on the same chart and I was shocked at what he showed me. She was devestatingly small, falling into the third centile, a fact that I never fully comprehended until today when I saw how far from the normal range her weight had strayed. It was heartbreaking to imagine that she was almost a month behind with her growth. For the first time since we lost her it appeared glaringly obvious that she was failing to thrive in the womb. What breaks my heart the most is that I had no idea. 

When I was 28 weeks pregnant with Nieve, I attended my normal midwife appointment where the protocol is to measure the pregnant woman’s abdomen with a tape measure in order to gage whether the baby is growing sufficiently. This is a sixty year old practice and in heinsight it feels like such a primitive, unreliable and ultimately irresponsible way to judge how a baby is developing. The midwife with her tape measure deemed that Nieve was measuring perfectly and I never doubted it. I continued on my merry way, reassured that my baby was doing well and totally oblivious to the fact that she was struggling. 

If only the UK offered scans at 28 weeks then I’m almost certain that Nieve’s issues would’ve been picked up. I’m reminded that thinking this way is fruitless or that plenty of babies are born small every day. It isn’t enough. It now feels ludicrous to me that babies in the Uk are generally only seen twice on an ultrasound and that there is a twenty week gap between the ‘final’ ultrasound and the birth. It feels so blasé to presume that everything will be fine with a baby after twenty weeks. It’s like taking a gamble on the odds that things will ‘probably’ be ok. Most of us pregnant women happily oblige with these protocols; but we are misled by reassuring medical professionals and a dark secret that stillbirth is in fact so common. 

The statistics speak for themselves. In the UK there are more than 3,600 stillbirths a year, and one in every 200 births ends in a stillbirth. Most of the affected babies are from low risk pregnancies, yet extra monitoring is only offered to those who are deemed high risk; a status that then only applies to you once you’ve lost a baby. It’s too little too late. 

Eleven babies are stillborn every day in the UK, making it 15 times more common than cot death. Yet cot death is such a widely publicised phenomenon, while stillbirth receives very little publicity. It leads me to wonder whether babies in the womb are regarded with lesser importance than those who have taken their first breath. Are unborn babies out of sight, out of mind?

Wishing that systems to monitor babies in the womb were more robust may indeed be a fruitless exercise for me. It won’t bring Nieve back. But what about the next family? What about the dozen families in the UK who will lose their babies tomorrow, and the next day? And the next? If more monitoring of babies in utero could help just a few more babies survive wouldn’t it all be worth it? 

Professor Gordon Smith of the stillbirth alliance says, “Stillbirth is a relatively ignored problem which accounts for the potentially preventable loss of large numbers of babies. There are aspects of stillbirth which indicate that the relatively high levels could be reduced by novel methods of screening coupled with safe and effective intervention.”

I’m inclined to believe that our current protocols to monitor unborn babies are driven by budgets rather than by what is the best for babies and that makes me angry. If I had any inclination of even the slightest risk to my baby I would’ve paid for private scans myself.

It seems we have too much trust in medical systems. We presume that protocols are driven totally by the wellbeing of our babies but it’s a tragic and very sobering fact that despite living in one of the wealthiest countries in the world, budgeting/ cutting costs is probably the driving force behind the amount of monitoring for babies in the womb. 

A woman in my online pregnancy group was recently told that her baby was measuring small. She was reassured by another poster who said “If it’s any consolation, in Sweden we only get a scan at 20 weeks, and that’s it. So I presume the Swedish government thinks growth abormalities are so standard and usually work out totally fine that they don’t bother tracking it!” Such naive faith; and it reflects how most of us think. We put faith in medical systems but the fact is that we live in an era where money and business are the ruling force.

My future pregnancies will be highly monitored, but what about all those babies who slip though the net? It isn’t enough for me to know that I will now get the level of monitoring that Nieve deserved, that all babies deserve.

The issue is that nothing will change whilst stillbirth remains such a taboo subject. Stillbirth is the great unmentionable. Medical professionals avoid speaking to pregnant women about it for fear of scaring them but that does them a disservice. A loss mum friend of mine was actually asked by her midwife to refrain from sharing her story with the other pregnant ladies in her antenatal class lest she alarmed them. The same taboo surrounded Down’s syndrome and Cot Death once in a day, but we now talk openly about these subjects and it’s about time we did the same with stillbirth. 

More awareness is needed and it starts with loss mum’s like me being open to sharing my story, but I fear that most of the time, it will only reach the ears of those who have been touched by tradgedy themselves. 

I regularly read online posts from other pregnant women worried about baby movements or growth. I listen as other posters offer reassuring advice and I feel torn; torn by my desire to inform others about the risk of stillbirth versus a fear of being seen as scaremongering. I think the issue is that people often use online communities for reassurance and the truth is that they only truly desire positive input. The other issue is that people like me probably do instill fear in others. My story is filled with my own emotion and specific circumstances and lacks concrete facts and figures. Perhaps I overestimate my role in raising awareness and it would be better left to medical professionals. If only they would step up. 

Until the day that stillbirth is given a bigger profile I don’t really see how anything can change. Eleven babies will die today and the devastation that that brings has a ripple effect over parents, families and communities. We can’t continue to bury our heads in the sand. 

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