Preventing stillbirths

Preventing stillbirths
Jul. 28, 2003 12:00 AM


Your articles on stillbirth (Arizona Living, July 17) raised important issues.

The loss of a wanted child is a terrible tragedy for any family. There is a 
great deal that can be done to prevent stillbirths. The most important thing is 
to get early and adequate prenatal care. Women who do not get prenatal care are 
at least seven times as likely to suffer a stillbirth. 

Unfortunately, Arizona ranks 46th of the 50 states in the percentage of women 
who get adequate prenatal care. In 2002, only 68.4 percent of the women who 
delivered in Arizona got adequate prenatal care. 

There are many barriers to prenatal care in Arizona, including education, 
finances, transportation and language. It is important that we seek ways to 
overcome these barriers. Every dollar spent in prenatal care has been shown to 
save $3.30 in newborn care and another $4.63 in long-term care of children.

As stated in your article, monthly ultrasounds and "fetal physicals" do cost 
thousands of dollars, and many mothers would pay for them. Unfortunately, these 
tests have not been shown to be effective in preventing stillbirths. "Cords 
around the neck" are actually less common in stillbirths than in live births and 
nuchal cords rarely, if ever, cause stillbirth. 

Although many stillbirths are unexplained, often the cause can be determined. A 
work-up to find known causes of stillbirth may result in prevention of a future 
pregnancy loss. Routine prenatal care is designed to find and treat the common 
causes of preventable stillbirth, and all women should have access to prenatal 
care. 

J. Chris Carey 
Paradise Valley
The writer is chairman of obstetrics and gynecology at Maricopa Medical Center.

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