Poorer mothers three times ‘more likely to have stillborn children’

Maya Oppenheim
·6-min read
The government has been urged to take immediate action to address the social determinants of health and halt the rise in pregnant women who face the stress of financial insecurity (Getty)
The government has been urged to take immediate action to address the social determinants of health and halt the rise in pregnant women who face the stress of financial insecurity (Getty)

Poorer mothers are three times more likely to have stillborn children than those from more affluent backgrounds, according to a new study.

The wide-ranging research, conducted by pregnancy charity Tommy’s, also found that high levels of stress doubled the likelihood of stillbirth, irrespective of other social factors and pregnancy complications. Unemployed mothers were almost three times more at risk.

The government has been urged to take immediate action to address the social determinants of health and halt the rise in pregnant women who face the stress of financial insecurity.

Lucy Wakeling, a 26-year-old from Worthing who gave birth to stillborn daughter Hope in July 2018, said she had a stressful pregnancy which was exacerbated by the emotional abuse she experienced at the hands of her ex-partner.

Her ex did not want the baby and ended the relationship when she was seven weeks pregnant, Ms Wakeling said.

She said: “He was so unpredictable, one minute wanting to be involved and the next threatening to ‘take the baby away as soon as you’ve finished breastfeeding’, saying my bump was small and accusing me of not looking after myself when I’d lost my appetite from stress.

“At 25 weeks pregnant, I cut contact with him until I invited him to the baby’s funeral, where he told me this wouldn’t have happened if I’d just had the abortion he wanted.

“It’s taken me a really long time to come to terms with such a heartbreaking loss, but the doctors said it shouldn’t happen again — so although I struggle to imagine it, I look forward to the day I can hold my baby, alive and healthy.”

Stillbirths, which refers to when a baby is born dead after 24 weeks of pregnancy, occur in around one in every 200 births in England. The stillbirth rate in the UK is 24th out of 49 high-income countries.

Researchers at the University of Manchester’s Tommy’s Maternal and Fetal Health Research Centre examined more than 1,000 births across 41 UK hospitals between 2014 and 2016.

Louise Joines, who lives in London, gave birth to her stillborn son Gabriel in December 2017 after enduring a very psychologically stressful pregnancy.

The 36-year-old, who did have a physically healthy pregnancy, said she was juggling an intensely busy job as a deputy headteacher with looking after her two children at home while getting no support from the baby’s father.

Ms Joines asked to see a mental health specialist while she was pregnant but was not referred — adding that she now thinks seeing one could have saved her baby.

She said: “I found out I was expecting Gabriel just as I ended a strained relationship with his dad, so it was a very stressful pregnancy from the start. I told my midwife about my situation but sadly nothing came of it, so that’s a big ‘what if’ — a friend who had mental health care during pregnancy wasn’t allowed to go past 40 weeks, and Gabriel was born at 41 weeks, so perhaps if I’d been given the right support he would be alive today.

“We need better systems to protect pregnant mothers, and I hope that sharing Gabriel’s legacy will help to prevent other families losing a baby.”

Researchers said getting more antenatal care can stop women from having a stillbirth — with mothers who went to more appointments than national rules stipulate having a 72 per cent lower risk.

Sophie Tugwell, who is from Cardiff, said she had check-ups every other day for almost a month after a normal scan showed she had a very small baby and argued getting this extra care allowed her son to be safely born.

Ms Tugwell, whose son is now seven-months-old, said: “If the hospital hadn’t kept such a close eye on us, I might have never had the chance to come home with a baby.”

Researchers found it difficult to account for why there was such a stark difference in the stillbirth rate for different women — saying studies aren’t always able to take into account other risk factors linked to deprivation, such as education, housing circumstances, and immigration status.

Jane Brewin, Tommy’s chief executive, said: “This research shows that stillbirth is not a problem we can solve with healthcare alone. The complex relationships identified here between stillbirth and social stresses make it clear that the government’s prevention strategy must extend beyond the NHS to tackle these deeper underlying issues within society.”

Ros Bragg, director of Maternity Action, told The Independent there is an “urgent need” for the government to take measures to tackle poverty and deprivation in pregnancy.

She said it is known that “good employment, decent housing and well-funded maternity pay and benefits” are crucially key to ensuring the good health of pregnant women and their babies.

Ms Bragg added: “On our advice lines, we are hearing from an increasing number of pregnant women who have lost their jobs and are relying on the social security system to meet their basic needs.

”Statutory maternity pay is equal to half the minimum wage for a 35 hour week, which is wholly inadequate to support a family.  An anomaly in the Universal Credit regulations leaves women on Maternity Allowance up to £5,000 worse off than those on Statutory Maternity Pay.  For migrant women, hostile environment policies can mean destitution in pregnancy and while caring for a new baby.

“If the government is serious about combatting stillbirths, it must address the social determinants of health as well as clinical care. Women need safe, secure employment during their pregnancy and the certainty of a decent income if they find themselves out of work. It is not right that increasing numbers of pregnant women are dealing with the stress of financial insecurity, putting them at increased risk of serious health problems, including stillbirth.”

While around 14 babies die before, during or soon after birth each day in the UK, baby loss remains a massively taboo subject. Campaigners recently told The Independent women who lose their child after suffering a miscarriage, stillbirth or neonatal death are let down by a lack of counselling and support to help them deal with the trauma.

Women often get distressing news their baby has died in tiny cramped windowless rooms and busy outpatient areas — with women and partners saying health professionals were insensitive or that they felt rushed after hearing traumatic news. The global pandemic has deeply exacerbated pre-existing issues, as social-distancing rules have blocked partners from going to antenatal appointments.

Professor Alex Heazell, an obstetrics professor at the University of Manchester who is the study’s author, said: “We know people are more likely to disclose issues such as stress and domestic abuse to a professional if they have a good relationship with them and believe that person can help.”

The Independent recently spoke to women whose lives have been irrevocably changed after losing their baby through a miscarriage, stillbirth or neonatal death to mark Baby Loss Awareness Week which falls at the beginning of October every year.

Read more

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5 things you may not know about miscarriage and stillbirth