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Stillbirth: What to look out for to reduce your risk

REDUCING RISK: There are some red flags that parents can to look out for to lower the chance of their baby being stillborn

AS OTHER areas of medicine have advanced, the rates of stillbirths have remained high, with and estimated nine babies a day dying before they are born in the UK. The fear around stillbirth means it is rarely spoken about, leaving expectant parents with little knowledge of what warning signs to look out for to prevent having a stillborn baby. In a third of stillbirths, no cause or risk factor is found, but there are some red flags that parents can to look out for to reduce their risk of their baby being stillborn.

1. A change in your baby’s movements

Your baby will start to move from 16 weeks and eventually development a predictable pattern of movement at around 24 weeks. Your baby will then continue to move every day until they are born. Pay attention to when your baby tends to move and what noises, positions or food tend to stimulate them to have a wriggle.

If your baby is unwell or under any stress, the first thing they will do is conserve energy by reducing their movements. Knowing their behaviours intimately will alert you to any minor change in their movements. Some mothers use the count the Kicks Count App to keep track of their baby’s movements and identify any concerning change.

Contact your midwife or hospital as soon as you are concerned about your baby movements. Do not wait for the next morning, or after the weekend. Do not worry what people will think or if you have just been at the hospital earlier the same day. The situation can change quickly and all health care professionals will take your concerns seriously.

PICTURED: Dr Tamara Bugembe

2. Swelling and tiredness

High blood pressure in pregnancy plays a role in approximately 7 per cent of stillbirths. The signs of a rising blood pressure are subtle and easily hidden within the expected changes of pregnancy. Attending your antenatal appointments and having your blood pressure monitored will make it possible to identify high blood pressure early.

However, a change in blood pressure can happen in between your appointments. Look out for sudden or extreme swelling, excessive tiredness, frothy urine and persistent headaches. A blood pressure check is an easy, non-invasive process. If you are worried about any of these symptoms, do not put it off passing by your GP surgery, hospital or even some pharmacies to have it checked.

3. Itching

Pregnancy puts stress on the liver creating complications that we now know are associated with an increased risk of stillbirth. One of the earlier signs of liver dysfunction is itching due the accumulation of substances the liver is failing to clear. With early identification and monitoring, mother and baby can be kept healthy until delivery. Let your midwife know if you develop persistent itching and she will arrange for a blood test to assess your liver function.

4. Abdominal pain

Our body often uses pain to let us know that things are not right. If a situation arises that is puts the baby at risk, you body may try to expel the baby early. Cramping stomach pains may signify an infection or problems with the placenta or uterus. During the pregnancy you will experience some stretching and discomfort, but any unusual abdominal pain should be looked into. Do not wait to see if the pain becomes unbearable or persists for a certain period of time. We would rather be seeing you to reassure you that everything is okay, than be dealing with a crisis.

5. People with infections

Be aware of and avoid people with contagious infections, however minor. Your immune system will have to pull back in order to accommodate your baby and not attack it as “foreign invader”. This leaves it unable to fight minor infections that cause little discomfort to most adults. Avoiding exposure to the infections while your immune system is compromised is the best way to reduce the risks to you and your baby. You can also support your immune system by eating healthy foods, avoiding foods with live bacteria (eg. blue cheese and sushi) and taking folic acid and vitamin D. Having the flu and rubella vaccines will also boost your immunity and reduce the chances of passing fatal infections onto your child.

Other simple changes that can reduce the risk of stillbirth are reducing smoking alcohol intake, lying on your side during the third trimester to improve blood flow to the baby, staying a healthy weight during the pregnancy and avoiding home doppler monitors or any other devices that create false reassurances.

Dr Tamara Bugembe is a paediatrician, and the founder of which supports parents and families.

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