Stillbirth is a sad subject, and not a popular front page topic. One thing I appreciate about the British paper The Guardian, and also the BBC, is that they routinely address women and baby wellbeing in their journalism; articles on pregnancy, birth, postpartum, working mother benefits and child welfare statistics show up with much more frequency than in American papers and media.
While I recognize that a system of national health such as they have in England has its problems, one thing that Americans do not seem to realise is that mother-baby outcomes are predominantly determined by access to care. Duly, in America your economic or educational status determines your likelihood of a serious problem when it comes to pregnancy, birth, postpartum and your baby’s well being. Because there is already a cultural and economic system in a place in the UK that acknowledges a basic right to heath care, it seems the press covers these topics with much more gusto, thoroughness, more factual basis and quality than we get in American papers.
So when the BBC reports on the need to improve baby outcomes what gets called for is: (shocking I know) but more prenatal care access for all women, longer visits so pregnant women get the attention they need, more nurses and midwives and consultant doctors, and one-to-one care for sick and premature babies. These are all things that in the United States would be buried by fear of the cost, accusations of socialism, the insurmountable liability premiums, and the time suck that we do not consider valuable.
But ultimately, when you have a government with limited budget not designed to profit off its health care, rather than a profit-oriented private industry, accountable for health care cost, it seems that evidence-based medicine which achieves good outcomes at effective costs, wins. For example, the UK has gone from 1% to 2% homebirth rate in the last few years due to a specific education and practitioner push to make homebirth more accessible. For women having low risk pregnancies (i.e. normal pregnancies) the Royal College of Obstetrics agrees it’s a cost effective safe way to give birth as compared to crowded, busy hospitals where infection rates are climbing.
Yet the primary difference in the article is the call to action, the request for more support for medical care, the numerous possibilities suggested that could change outcomes for the better - not finger pointing, victimization, lawsuits or an ‘it’s just too big of a problem’ attitude. It allows one to read the article with compassion and hope that - even while it’s a sad and devastating topic - we can make a change.
In reading the recommendations from the BBC for more staffing and longer prenatal visits, I am reminded of the hundreds of times in my fourteen years of teaching I have heard students complain about their cursory abrupt visits with their practitioners. Most women sigh and resign themselves, believing that this is the standard in our current system for prenatal visits. What is important for families to know is that there are many doctors and midwives who take time with each visit to answer questions, and update the woman as to what she should be looking for at this point in her pregnancy. Practitioners that say "we will talk about that later" or "let me worry about that" are the practitioners that are not encouraging women to educate themselves and really understand the variables in pregnancy and birth.
What practitioners who patronize women in this way fail to understand is that this is less likely to create an environment of trust. And trust is vital in this area. It’s important if something out of everyone’s control happens that the client actually does trust that the doctor or midwife did everything they could to help because the women and practitioner together understand how the process works.
If you want info on the range of care and how to know if you are getting great prenatal care than check out our Real Baby, Real Body Talk and find out why raising your expectations in the short term creates better health in the long term!
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