Intended for healthcare professionals

Reviews Soundings

Giving up on getting better

BMJ 2006; 333 doi: (Published 29 June 2006) Cite this as: BMJ 2006;333:51

Reasons for increased stillbirth rate?

Professor Drife is right to question why stillbirth rates are once
more rising. However before putting this down to increased community based
care I would suggest considering the following occurences since 2002:

1.As he suggests, there are less community based midwives who are
overstretched and expected to do much, much more at the expense of
valuable time being with women, with less opportunity for consistent, same
person care

2.The population of women from less developed countries, either ariving
pregnant or living in poverty within our country has increased.

3.The NICE guidelines for antenatal care have been introduced

However,women are being offered more antenatal screening and
ultrasound scans from an earlier time and the casearen section rate has
continued to rise. Despite the interventions Professor Drife is advocating
it appears to be making no difference to the numbers of babies dying.
Perhaps considering how we can improve the first three situations will
make a difference.

Competing interests:
Midwifery Lecturer and Editor of The Practising Midwife journal
Mother who has birthed at home

Competing interests: No competing interests

04 July 2006
Jenny S Hall
Midwifery lecturer