An international expert is warning that Australia could see a sharp rise in the number of stillbirths during COVID-19 due to changes in guidelines for pregnant women.
A recent study in a large UK maternity hospital revealed a four-fold increase in stillbirth during the pandemic - and Associate Professor Jane Warland fears this alarming outcome will be replicated in Australia.
"Australians should be concerned because other high-income countries like England and Scotland have experienced this spike during their lockdowns," she tells Essential Baby.
The international researcher and qualified midwife, who lost her own daughter Emma to stillbirth in 1993, says the evidence from St George's University Hospital in London, was not due to women or babies being infected with COVID-19.
"Rather, it is the indirect consequences of expectant mothers being told to stay away from hospitals for fear of contracting the virus or overloading the system," she says.
"Many high-risk pregnancies were missed, resulting in four times as many stillbirths than usual."
The University of South Australia academic says that professional health organisations around the world quickly changed the guidelines for pregnant women when the pandemic hit, which may have led to unintended consequences.
"The normal recommendation is that women should see their caregiver at least seven times during their pregnancy," she explains.
"This ensures that any red flags – such as high blood pressure, reduced fetal movements and growth restriction – are all picked up during an examination.
"Instead, expectant mothers have been directed to 10-minute tele health appointments via phone and Zoom. How can you check someone's blood pressure or do a physical examination over the phone?"
In Australia, six babies are stillborn every day, equivalent to about 2200 each year - and unfortunately stillbirth is more common in first-time mothers, who are more vulnerable and less aware of potential abnormalities.
"That's why face-to-face care is so critical during their pregnancy," Professor Warland says, adding that home visits by midwives and caregivers could be a viable option until the pandemic is brought under control
"In normal circumstances they are highly vulnerable, but this pandemic has escalated that vulnerability and stress to new levels.
"We need to urgently look at the COVID antenatal care guidelines and find ways to support them that doesn't put their life, or their unborn baby, at risk."
A recent survey of almost 3000 women by the Australian College of Midwives also revealed just how worried pregnant women are amid COVID-19.
"Women – first time mums particularly – are voicing their concerns about not being seen, forgotten, ignored and scared that their baby might be at risk without regular health checks," says Professor Warland.
A further complication due to COVID-19, is the suspension of a new program recommending pregnant women sleep on their side from 28 weeks as there is sound evidence women who sleep on their backs are more at risk of a stillbirth.
With August 14 being Red Nose Day, it's an important opportunity to support families who have been impacted by the death of a baby or child.
"When my daughter Emma was stillborn I had amazing support from the midwives as well as my family and friends," says Professor Warland.
"I am particularly mindful that families who have lost a baby to stillbirth this year have done so in the context of physical distancing. I can only image how very tough that must be."
And while we won't know for sure about the increased risk of stillbirth in Australia until the national statistics come out in 2023, Professor Warland has important advice for any women who are currently pregnant.
"Be careful to attend all your appointments - both telehealth and face-to-face - and do not be afraid to quickly report any concerns."