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Reducing stillbirth safely in Australia

Roshan Selvaratnam, Mary‐Ann Davey and Euan M Wallace
Med J Aust 2020; 213 (1): . || doi: 10.5694/mja2.50658
Published online: 22 June 2020

Caution is needed so that population‐level reductions in the stillbirth rate are not offset by iatrogenic harm to healthy babies

The federal Minister for Health the Honourable Greg Hunt MP recently launched the Safer Baby Bundle — a national stillbirth program that aims to reduce stillbirth in Australia by 20% by 2023.1 The program is one of the responses to recommendations arising from the federal Senate's Select Committee on Stillbirth Research and Education.2 It draws from similar bundles of care in the United Kingdom that have been associated with successful reductions in stillbirth.3,4 Undoubtedly, these whole‐of‐population level programs are important and effective. However, because late pregnancy stillbirth can be prevented simply by delivering all babies early, they have the potential for harm.


  • 1 Monash University, Melbourne, VIC
  • 2 Safer Care Victoria, Melbourne, VIC


Correspondence: euan.wallace@monash.edu

Acknowledgements: 

Euan Wallace is the recipient of a National Health and Medical Research Council (NHMRC) Program Grant (APP1113902). Roshan Selvaratnam has been granted a PhD Scholarship Top‐up from the NHMRC Stillbirth Centre of Research Excellence (APP1116640).

Competing interests:

No relevant disclosures.

  • 1. Centre of Research Excellence Stillbirth. Safer Baby Bundle handbook and resource guide: working together to reduce stillbirth. Stillbirth CRE, 2019. https://resources.stillbirthcre.org.au/downloads/SBB+Handbook_Final.pdf (viewed Nov 2019).
  • 2. Parliament of Australia. Select Committee on Stillbirth Research and Education report. Canberra: Commonwealth of Australia, 2018. https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Stillbirth_Research_and_Education/Stillbirth/Report (viewed Nov 2019).
  • 3. NHS England. Saving Babies’ Lives: a care bundle for reducing stillbirth. London: NHS England, 2016. https://www.england.nhs.uk/wp-content/uploads/2016/03/saving-babies-lives-car-bundl.pdf (viewed Nov 2019).
  • 4. Healthcare Improvement Scotland. Scottish Patient Safety Programme Maternity and Children, end of phase report. Edinburgh: HIS, 2016. https://ihub.scot/media/2317/spsp-mc-eopr.pdf (viewed Nov 2019).
  • 5. Selvaratnam RJ, Davey MA, Anil S, et al. Does public reporting of the detection of fetal growth restriction improve clinical outcomes: a retrospective cohort study. BJOG 2019; 127: 581–589.
  • 6. Monier I, Blondel B, Ego A, et al. Poor effectiveness of antenatal detection of fetal growth restriction and consequences for obstetric management and neonatal outcomes: a French national study. BJOG 2015; 122: 518–527.
  • 7. Bentley JP, Roberts CL, Bowen JR, et al. Planned birth before 39 weeks and child development: a population‐based study. Pediatrics 2016; 138: e20162002.
  • 8. Stacey T, Thompson JMD, Mitchell EA, et al. Maternal perception of fetal activity and late stillbirth risk: findings from the Auckland Stillbirth study. Birth 2011; 38: 311–316.
  • 9. Grant A, Valentin L, Elbourne D, Alexander S. Routine formal fetal movement counting and risk of antepartum late death in normally formed singletons. Lancet 1989; 334: 345–349.
  • 10. Norman JE, Heazell AEP, Rodriguez A, et al. Awareness of fetal movements and care package to reduce fetal mortality (AFFIRM): a stepped wedge, cluster‐randomised trial. Lancet 2018; 392: 1629–1638.
  • 11. Heazell AEP, Weir CJ, Stock SJE, et al. Can promoting awareness of fetal movements and focussing interventions reduce fetal mortality? A stepped‐wedge cluster randomised trial (AFFIRM) protocol. BMJ Open 2017; 7: e014813.
  • 12. Shah A. Using data for improvement. BMJ 2019; 364: l189.
  • 13. Sovio U, Goulding N, McBride N, et al. A maternal serum metabolite ratio predicts fetal growth restriction at term. Nature Med 2020; 26: 348–353.
  • 14. Bradford BF, Cronin RS, McCowan LME, et al. Association between maternally perceived quality and pattern of fetal movements and late stillbirth. Sci Rep 2019; 9: 9815.

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