Implementation of the Perinatal Society of Australia and New Zealand Guidelines for Perinatal Mortality

Improving clinical practice in maternity hospitals to reduce stillbirth and neonatal death and provide appropriate bereavement care for parents.

The death of a child is among the most devastating life events an adult may experience in their life. In Australia and New Zealand (ANZ), 10 babies die every day through stillbirth and neonatal death.

Despite the frequency of this loss, thorough investigation and review of possible causes is often lacking, resulting in loss of important information to help explain why the baby died.

In ANZ, up to 30% of stillbirths are unexplained. However, the lack of comprehensive investigation in many instances may mean that a cause was missed.

Adequate investigation is essential in helping parents to understand “what went wrong” which may help in recovery from the loss and also in planning future pregnancies. A better understanding of these deaths enables practice changes aimed at reducing the number deaths.

In order to improve clinical practice around the time of perinatal death, the Perinatal Society of Australia and New Zealand developed national clinical practice guidelines in collaboration with professional colleges and SIDS and Kids and SANDS. From the experience of the multidisciplinary team involved in the guideline development over many years working parents who suffer the tragic loss of a baby, it was clear that improvements in the care provided was urgently needed. Therefore, in addition to recommendations about investigation of these deaths, the guideline also aimed to improve bereavement care for parents.

However, a recent survey of midwives and doctors across Australian and New Zealand hospitals clearly showed that many were not following the guideline. The Australian and New Zealand Stillbirth Alliance in collaboration with PSANZ and member organisations have developed a program to assist health care professionals in using the guideline when caring for families whose baby dies. An important part of this program is the educational program -IMPROVE (IMproving Perinatal Review and Outcomes Via Education) – an interactive educational program. The program will be undertaken across maternity hospitals in 2010 and will include an evaluation to measure how successful the program has been.

The main aim of the implementation program is to improve the information available on the causes and contributing factors for stillbirths and neonatal deaths with the goal of reducing these deaths. Further, this project aims to improve bereavement care for parents following a stillbirth or neonatal death in Australian and New Zealand maternity hospital settings.

The summary report on the evaluation of the IMPROVE program can be downloaded here.