Heartbreaking decision made after twin’s stillbirth

 

Lauren Martyn-Jones' first instinct when she was asked to consider an autopsy after the stillbirth of one of her identical twin girls was: 'No, you're not touching her.'

"It just seemed to be a bit brutal and a bit senseless, given I'd lost her and what could that achieve?" she said.

But when she was advised about the possible benefits for her surviving twin, Lillian, who recently turned four, and for potential future pregnancies, she and her husband Matt, agreed.

Lily and her stillborn twin, Audrey, were born at 34 weeks' gestation in the Mater Mothers' Hospital on March 21, 2017.

Lauren and Matt with their daughters Eleanor, 2, and Lily, 4. Their daughter Audrey was stillborn. Picture: Nigel Hallett.
Lauren and Matt with their daughters Eleanor, 2, and Lily, 4. Their daughter Audrey was stillborn. Picture: Nigel Hallett.

"Because Audrey was an identical twin … I wanted to make sure there was nothing I needed to know that might have had an impact on Lily's health," Ms Martyn-Jones said.

"That was the most compelling reason and because I had in my mind that we would try and have another baby, I wanted to know if there was anything they could tell me that would change the way they cared for me the second time around."

As they grieved for the loss of Audrey, the Martyn-Jones's made the difficult decision to consent to an autopsy, reassured by the Mater's medical team about how respectfully their daughter would be treated during the process.

Lauren Martyn-Jones gave birth to twins Audrey and Lily four years ago. Audrey was stillborn. Photo: Nigel Hallett.
Lauren Martyn-Jones gave birth to twins Audrey and Lily four years ago. Audrey was stillborn. Photo: Nigel Hallett.

"We had a farewell ceremony, a naming and blessing, before she went to the autopsy but they told me that if I wanted to, I could have seen her after," Ms Martyn-Jones said.

Although the results were inconclusive, she said having the autopsy was the right decision.

"I think if we hadn't done it, then I would always have questioned whether I could have done more to find out why I lost my baby girl," Ms Martyn-Jones said.

She has since given birth to a healthy daughter, Eleanor, 2.

 

AUTOPSY COULD HELP PARENTS GAIN ANSWERS

 

Dozens of late gestation stillbirths in Queensland have no identifiable cause, a new study shows.

Researchers analysed 56 stillbirths that occurred in 2018 across Queensland at 34 weeks' gestation and later, finding more than half were unexplained.

Stillbirths were excluded if the baby had a significant abnormality or if insufficient information was available to the researchers about the in-utero death.

With just 37 per cent of parents consenting to an autopsy after a stillbirth in Queensland, one of the study's authors, Griffith University's dean of medicine David Ellwood, said improved investigations into the causes could help prevent more cases in future.

 

Professor David Ellwood, co-director of the Mater Research Institute's Stillbirth Centre for Research Excellence. Picture: Supplied.
Professor David Ellwood, co-director of the Mater Research Institute's Stillbirth Centre for Research Excellence. Picture: Supplied.

"Historically, there's always been this view of stillbirth that it's just something that happens, we can't do anything about it, you can't predict it, you can't prevent it, it's just always going to be there," Professor Ellwood said.

"We don't believe that's the case. In terms of under-investigation, not having an autopsy is the big thing.

"What we say is that the counselling around autopsy should be carried out by a senior person who understands what's done as part of an autopsy and it should be explained to parents why it's a useful thing to do."

Prof Ellwood, who is also co-director of the Mater Research Institute's Stillbirth Centre for Research Excellence, suggested the cost of an autopsy for parents who had a stillborn child in the private sector may also be prohibitive, with no Medicare rebate for the procedure.

The study, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, found improved management of women with risk factors, such as gestational diabetes, fetal growth restriction and decreased fetal movement, may reduce their risk of having a stillbirth.

After decades of the Australian stillbirth rate remaining relatively stable, Prof Ellwood said researchers were starting to see a reduction in those occurring in the later stages of pregnancy.

He said that since studies had identified the risk of stillbirth increased in pregnancies that continued past 40 weeks, induction of labour had become more common.

"Babies are being born a little bit earlier than they used to be born. I think that's contributing to some of the decline in stillbirths," Prof Ellwood said.

He said the big hope was that Australian stillbirth rates would further decrease with the introduction of the "Safer Baby Bundle", which aims to raise awareness among women and their health providers about key stillbirth risk factors.

They include encouraging pregnant women to quit smoking, to sleep on their sides rather than their backs, to improve their awareness of the importance of decreased foetal movements in stillbirth risk and to increase the detection of foetal growth restriction.

"There isn't one thing that will fix the problem of stillbirth, there's a whole lot of different approaches," Prof Ellwood said.

In Australia, stillbirth is defined as the birth of a baby without signs of life after 20 weeks' gestation or 400g birthweight.

Queensland recorded 463 stillbirths in 2019.

 

For support after a stillbirth:

Stillbirth Foundation 02 9557 9070 or stillbirthfoundation.org.au

Red Nose Australia: 1300 308 307 or rednose.org.au

 

Originally published as Heartbreaking decision made after twin's stillbirth