Bernice Addom (left), Chairperson, Maternal and Child Health, West African Postgraduate College of Nurses and Midwives, Ghana Chapter, in a discussion with Charlotte Van Noorlo, an obstetrician gynaecologist from the Netherlands, during the conference. Picture: EDNA SALVO-KOTEY
Bernice Addom (left), Chairperson, Maternal and Child Health, West African Postgraduate College of Nurses and Midwives, Ghana Chapter, in a discussion with Charlotte Van Noorlo, an obstetrician gynaecologist from the Netherlands, during the conference. Picture: EDNA SALVO-KOTEY
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Stillbirth trauma: Health authorities move to support parents

In Ghana, stillborn babies are usually removed from the sight of their parents quickly after birth. 

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Not seeing the child, it was thought, would lower the attachment and make it easier for the parents to deal with the loss. 

However, it has now been established that the opposite is rather the case per the statistics of best practices, hence the move by health authorities to reverse the trend.

The trauma that parents endure from stillbirths is such a disturbing ordeal which has compelled the King of Kings Healthcare Services in Ghana to embark on a mission to help mothers to preserve memories of their stillborn babies.

For instance, The Netherlands example of preserving the memories of stillborn babies, referred to as “Angel babies”, which include taking pictures of their footprints and if possible handprints, as well as the water method, has been proven to be easier and relatively cheaper in keeping the memories of such children. 

Statistics

A stillbirth is the death of a baby after 24 weeks of pregnancy or during birth.

Ghana is reported to have one of the best stillbirth rates of about 12 cases per 1,000 live births. 

However, the situation is different for the continent which averages 21 stillbirths out of every 1,000 births. 

In Nigeria, for example,  the most populous country in Africa recorded 42.9 stillbirths per 1,000 live births.

The Korle Bu Teaching Hospital recorded 32 stillbirths out of every 1,000 births delivered at the hospital last year, a statistic that has alarmed health professionals.

The figure is nearly three times the average 12 stillbirths per 1,000 births recorded for the entire country across the period.

From January to March, this year, the hospital has already recorded 30 stillbirths out of every 1,000 births.

Stillbirths

Describing stillbirth as an unpleasant birth outcome and a public health concern, the Chairperson of Maternal and Child Health of the West African Postgraduate College of Nurses and Midwives (WAPON), Dr Bernice Addom, pointed out that no midwife was ever delighted when a woman they saw throughout pregnancy lost the baby at the end, adding that midwives should support mothers and families that experienced stillbirth by giving the mother the opportunity to see, cuddle, touch and hold the baby in order to create memories.

She said in most developed countries, for every baby that was born — whether dead or alive — they created memories of them.

“They carried that baby in their wombs all this while. The fact that the baby is not alive doesn’t mean that emotional attachment is gone. Give the mother the opportunity to see and hold that baby to create memories. Moreso because, depending on how the mother goes through the experience, she might not get the opportunity to give birth again so it is for us to help such a mother to keep a memory of the dead baby,” she explained.

Training programme

She said this at a training programme on honouring the lives and preserving the memories of stillborns organised by Little Stars and Angel Babies for registered midwives and midwifery trainees in Accra last Tuesday.

The workshop was also to train the midwives on how they could offer psychological help to such mothers instead of just referring them to psychologists as was currently the practice.

As part of the training initiated by King of Kings Healthcare Services in Ghana, the midwives were taken through The Netherlands method so they could adopt it in their facilities and also train other midwives to adopt it gradually in the whole country.

Dr Addom stressed the need for midwives to take up the responsibility of providing psychological support for women in their care who lost their babies through stillbirth instead of referring them to psychologists.

“If a mother, whom you have been with throughout pregnancy ends up with stillbirth, don’t you think you are the best person to help her go through her grieving process instead of referring them to psychologists?” she asked.

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Dr Addom said most stillbirths occurred around the time of labour and delivery, and that was why the role of midwives in creating awareness on the subject was very important.

Risk factors

Dr Addom said every pregnancy had the risk of ending up in stillbirth, stressing, however,  that issues such as smoking, drinking alcohol and medical conditions like diabetes, pregnancy-induced hypertension or chronic hypertension, anaemia in pregnancy and infections posed a risk.

She said midwives, by their training, were more equipped to identify anything that was wrong with a pregnancy, and therefore advised them to quickly make referrals once they saw that something was not going well with a pregnancy.

The Netherlands example

An obstetrician gynaecologist nurse in labour and delivery from The Netherlands, Charlotte van Noorlo, explained that for the water method of preserving the memory of stillborns, all one needed were a bowl or a plastic container with a lid, tap water and ice cubes.

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“It can stay in water for approximately seven days but it differs per baby, the state of maceration and how cool you can keep the water. So it will keep good for about five to 10 days,” she explained.

When the stillborn baby is placed in this bowl or plastic container containing the tap water and ice, the water could be changed once a day but with the warm weather in Ghana, it was advised to use ice cubes and put new ones a few times a day.

She mentioned the advantages of the water method to include the fact that the fetus assumed natural posture, the skin became lighter, no distortion, one could take beautiful pictures as a reminder, the baby was easier to pick up because it was not as floppy and one could touch the child without damaging the skin.

With the footprint and handprint method, Ms van Noorlo explained that all one needed was a thin cardboard and a stamp pad. 

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“Once the baby is born, we try to make footprints within an hour or at least before the baby goes into the water. Just place the foot on the stamp pad. Then place the cardboard on one hand and take the foot in the other. Push the foot against the cardboard,” she explained.

With these methods, she explained, parents could keep memories of their stillborns.

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