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http://www.nytimes.com/2015/07/24/health/stillbirths-now-outnumber-deaths-among-infants-study-finds.html?&moduleDetail=section-news-2&action=click&contentCollection=Health&region=Footer&module=MoreInSection&version=WhatsNext&contentID=WhatsNext&pgtype=article

USA-Stillbirths Now Outnumber Deaths Among Infants-Study

By CATHERINE SAINT LOUIS - JULY 23, 2015

For the first time, stillbirths have slightly outnumbered deaths among infants before their first birthdays, a new report has found, ending a long period in which infant deaths were higher.

- has declined nationwide by 11 percent since 2006, but the mortality rate for fetuses in the second half of pregnancy has stalled, according to a report issued on Thursday by the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.

Lately, “we’ve made very little progress in reducing stillbirth in the U.S.,” said Dr. Robert L. Goldenberg, a professor of obstetrics and gynecology at Columbia University.

C.D.C. researchers found that 23,595 stillbirths occurred in 2013, compared with 23,446 infant deaths. Alabama, Mississippi, South Carolina, Puerto Rico and Guam had the highest rates of stillbirth, the report said.

Although a trend reversal, the difference was very small, noted Elizabeth Gregory, a health scientist at the National Center for Health Statistics and an author of the report. “There was less than 1 percent more fetal deaths,” she said.

Until relatively recently, public concern focused more on infant mortality than on stillbirth, partly because less was known about the incidence of stillbirth and how to prevent it, Mrs. Gregory and her colleague wrote.

Dr. Goldenberg, who was not involved in the new report, suggested that it nonetheless “should get people to focus” and redouble efforts to understand the causes of stillbirth and how to prevent it.

Some cases of fetal death after 20 weeks can be attributed to genetic abnormalities, obstetric complications, infection or issues with the placenta or umbilical cord. But often enough, no cause is found.

Racial disparities in stillbirth also remain a stubborn mystery. In 2013, non-Hispanic black women were twice as likely as non-Hispanic white women or Asian women to have a stillborn baby. Among black women, 10 fetal deaths occurred late in pregnancy per 1,000 live births, compared with 4.9 per 1,000 among white women and 4.7 among Asian women in 2013.

A 2006 study found that even when black women get access to early prenatal care, the racial disparity persists.

Pregnancy after age 35 appears to be an independent risk factor for stillbirth, even after accounting for the fact that risks like hypertension or diabetes are more common in older women, the authors wrote.

Still, pregnant teenagers under 15 were at highest risk for stillbirth, the researchers found. Mrs. Gregory suggested that having fewer socioeconomic advantages and biological immaturity might be contributing factors.

Male fetuses are at slightly higher risk of stillbirth than females over all, the report found, confirming previous studies.

Not all fetal deaths are reported as required by states, which may have hindered progress in lowering rates of stillbirth, Dr. Goldenberg said. If it were clear that a particular region had a high rate of stillbirths, that would probably “push the medical establishment and public health officials in that area to do something,” he said.

 

 

http://www.nytimes.com/interactive/2015/health/stillbirth-reader-stories.html

Stillbirth: Personal Stories

June 26, 2015

 

Few families are prepared when a baby dies prior to delivery. Here, parents who have navigated this difficult experience shared their insights.

Dr. Eleni Michailidis gave birth to a stillborn son. Read her story »

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Jennifer

Stillbirth on Nov. 16, 2009

My son is Abraham Amuhaya Imbula. He was born Nov. 16, 2009. The silence at his delivery penetrates my being. I remember his pregnancy, delivery, and the time we spent with him so vividly. I can still smell his scent. Our family valued our time with him. When my 2-year-old daughter, Gabriella, met Abraham, she said he is sick and needs a doctor and ran out to get a doctor. We held him and kissed him. We took photos. I trust his life was for a purpose. His memorial service was beautiful, with so many friends and family. Gabriella, his…

I don’t think you can prepare for a stillbirth - to prepare would be to give up hope, to imagine the worst.

Megan Scott

Stillbirth on May 25, 2010

Ever since losing my daughter when I was just 24 weeks pregnant, I've dreamed of becoming a superhero. When I read or hear about another family that's experienced a stillbirth, I want to don a disguise and fly to the mother’s side. I want to guard her front door, answer her phone, manage her Facebook account, intercept her text messages, anything that can shield her from the well-meaning, yet often thoughtless behavior of people.

Embrace the new, changed you and let go of any expectation of getting over it.

Aisha Oravec

Stillbirth on July 11, 2011

There is so much shame that comes in the moment of delivering a dead or dying baby. We feel like we should get the goodbye over too fast. Don't. We have so many hormones and feelings that want us to care for our newborn but you only get one chance - bathe, diaper, dress the baby, take pictures. Weigh and measure and footprint the baby. Talk to the baby and explore his body. Take lots of photos because you will want to remember the baby. You will need proof that he was really there when you are alone…

 

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Akeem Marsh

Stillbirth on Nov. 2, 2014

Welcome to the "exclusive club" that NOBODY wants to be a part of. Words cannot begin to describe the overall emotional, physical, and psychological intensity of the experience. It is a very painful, traumatic experience. If this happens to you, there are some things you can do to help ease the pain while honoring your loved one. Make sure that you spend time with the baby, holding the baby and take pictures. You can have professional photos taken free of charge by the organization Now I Lay Me Down to Sleep. This is something that will help keep your…

American society tells us we must be strong and that showing emotion is a sign of weakness. But that is wrong.

Christopher Benedetto

Stillbirth on Aug. 20, 2009

Take as much times as you need to embrace the grief and begin healing your body and soul. There is no time table for this, because enduring grief is different for each individual, and each couple. But there is no point trying to deny your pain or run from it because the grief will follow you and come like a thief in the night. It's been nearly six years since we lost our son and it took us almost two years of grieving to be ready to have another child. Since then, we've had two beautiful boys born to us.

It will take you a long time to not feel evil and sketchy around other pregnant women. Don't force that, it will come easier when it truly matters.

Rebecca Rood

Stillbirth on April 15, 2005

There is no right or wrong way to experience a stillbirth. When I was faced with the heinous news of a placental abruption and fetal demise due to preeclampsia in Week 30, the first words out of my mouth were 'pump me full of as many drugs as possible.' I commend all of those who still salvaged a birth experience and could see the beauty in the actual process. That was not me and I do not regret it. The pain and the joy still found me. Even doped up delivering in the ICU, I still felt the oxytocin rush…

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Credit Now I Lay Me Down to Sleep

Anica Martinez

Stillbirth on Nov. 19, 2013

We were 26 weeks into our first pregnancy with our sweet little girl, Brooklyn Skye, when our world made a change in a direction no one expected. Her movement decreased but being that it was my first pregnancy and still fairly early I was challenged with what my heart was telling me. The biggest heart break of a lifetime came when the nurse grabbed my foot when the ultrasound at the hospital showed no heart beat. Brooklyn was born still Nov. 19, 2013. No words can explain the pain that your heart and soul experience when you lose your…

Kailea Kjorlaug

Stillbirth on Jan. 30, 2015

My husband and I lost our daughter. After the first trimester you think you are in the clear. You won't lose your baby. I now know that is not true. I was 35 weeks pregnant when we found out my daughter didn't have a heart beat. My world and my life have never been the same after her birth. I know one in four pregnancies ends in either a miscarriage or a stillbirth. There are 26,000 families that experience stillbirth every year. I want to tell these families that they are not alone. The worst thing you could possible do…

Yes, it was weird. But I remember the relief everyone felt at being able to share that weird experience together.

Mark Werley

Stillbirth on April 1, 1994

I too remember the panicked look on the ultrasound technician's face and then the radiologist turning to face us with the news. Crying at home. Sharing news with family and friends (the first call was to our pastor who was remarkable - so helpful and understanding). Preparing for birth and delivery. Kind, kind, kind nurses who encouraged us to hold our daughter and spend time with her. Giving her a name - Hope. Then deciding to have her body cremated, hold a small memorial service to share our pain and with friends and family - rather than hide it away…

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Genevieve Gillette

Stillbirth on Feb. 17, 2014

We learned that our son Simon's heart stopped beating on Feb. 16, 2014 -- he was born Feb. 17, 2014 just one week shy of his due date. 6 pounds, 12 ounces, 20 1/4 inches, with beautiful wavy brown hair.