What constitutes a medical reason for preterm birth?

Stillbirth risk left out in latest guidelines for preterm birth

In a move to reduce preterm birth rates, an awareness campaign launched last month could potentially ignore important education that is proven to reduce stillbirth. Advocates for stillbirth prevention, Still Aware, are recommending all factors should be considered in the new guidelines to ensure a safe pregnancy for all families. 

Professor John Newnham (2020 Senior Australian if the Year) told the Advertiser on February 20; “The single biggest thing is to ensure that babies aren’t delivered before 39 weeks without a medical reason”. While in terms of preterm birth this information is vital, open communication is pregnancy care is also an important factor when recognising medical concerns.

In a third of all stillbirth cases at term (37+ weeks) the baby’s death remains unexplained. This doesn’t mean there is no risk or medical reason. Of the 5 biggest risk factors known for stillbirth, only one is medically diagnosable, so what constitutes a medical reason for preterm birth?

Still Aware advocates that every pregnancy is different, and there is no one-size-fits-all approach. The organisation encourages parents to follow their instincts, and to talk openly with their care providers if something doesn’t feel right. 

Claire Foord, founder of Still Aware, conducts the organisation’s free clinician education, backed by research, to help pregnancy care providers understand stillbirth and to talk openly about risks and preventable measures.

“This type of antenatal care is proven to reduce stillbirth in other countries,” Foord says.

“Active communication between expected families and their care provider is key. We encourage clinicians to feel confident in passing some of the responsibility in pregnancy care back to the expectant parents”.

Research shows that maternal intuition starts in pregnancy, and that when care providers are more open to the idea of trusting a mother’s instincts, they can best respond when a mother reports those feelings for a safe outcome.

“We need to look at the whole picture and ensure that information and decision-making is shared between mother and carer,” Foord says.

A recent study into the ‘gut feeling’ of expected mothers, reported that 65.5% of women who had experienced a stillbirth also experienced a ‘gut feeling’ that something was wrong[1]. The importance of listening to this intuition during pregnancy care is featured in Still Aware’s clinician education.

The new guidelines are backed by the Australian Preterm Birth Prevention Alliance and supported by the State Government and includes suggestions for clinician education on the known risks and complications of preterm birth. Meanwhile the Federal Government has launched clinician education under the Safer Baby Bundle program, which forms part of their National Stillbirth Action and Implementation Plan.

Preterm birth is defined as before 37 weeks’ gestation, while early preterm birth means delivering before 34 weeks.

Stillbirth is defined as the death of a baby beyond 20 weeks’ gestation, with 60% of stillbirth occurring at term.

For more information or to arrange interviews, please contact:

Claire Foord, CEO and Founder, Still Aware

claire@stillaware.org | 08 8300 0980 | 0438 252 848

Jessica Schulz, Communications Coordinator, Still Aware

communications@stillaware.org | 08 8300 0980 | 0433 849 396

[1] J. Warland et al. “They told me all mothers have worries”, stillborn mother’s experiences of having a ‘gut instinct’ that something is wrong in pregnancy.