I thank the Cathaoirleach for allowing me to raise on the Adjournment the lack of a stillbirths register in Ireland. I also thank the Minister for attending. I speak for those in the Irish Stillbirth and Neonatal Death Society who have campaigned for a stillbirths register since 1985.
When I was a medical student in the Rotunda Hospital 25 years ago, the attitude to stillbirths was completely different from that which prevails nowadays. The mother was often advised not to see her baby even though it might have been a perfectly formed child who had died just before birth or during labour. The views of the father were rarely considered, the role of the man in the production of small children being considered to be that of an obstetrician rather than a father. The Church did not bury such children and was often reluctant to say prayers over them.
That approach caused great distress for the mother and the father and, indeed, for the extended family. Parents, siblings, grandparents and neighbours look forward, with great joy, to the birth of a baby. It is a welcome event. How terrible then, in the event of a stillbirth, that it was dismissed as something that should be hushed up or not discussed. Those involved were often encouraged not to grieve openly which had an appalling effect, especially on the bereaved mother. One mother told me that she kept her dead baby's clothes and years later she used to hug them because she had never been permitted to touch the lovely child she had borne.
Fortunately, attitudes have changed. The parents are now encouraged to hold the baby and photographs are taken if desired. The Church will bury the child in a special ceremony and we all grieve with the bereaved parents. This is a more loving and responsive attitude. Some parents name the baby and its siblings are often encouraged to see the child and to grieve openly rather than pretend the event had never happened.
One pretence still continues: the State pretends that such births do not take place and does not register them. More than one stillbirth occurs every day in Ireland, yet ours is one of the only countries in the western world which does not register stillbirths. The reluctance of the State to set up such a register is hard to understand as registration would not only recognise the birth of the child, which has psychological importance for the parents, but it would also provide statistics regarding perinatal mortality rates.
The birth of stillborn infants should be registered in the same way as live born infants. The Masters of the three maternity hospitals in Dublin, in letters to the Irish Stillbirths and Neonatal Death Society, support the efforts of the society to establish a stillbirths register. They point out that such a register could assist investigations into perinatal births, as the causes of some such deaths are not known at present.
A stillbirth is a child who would have been viable but was born dead. Viability is usually considered possible from 28 weeks gestation, but due to improvements in the care of neonates or new born children, this has recently been revised in Great Britain to 24 weeks. Some countries favour a more scientific method of deciding when the child will be considered a stillbirth or a miscarriage. Usually this is taken to be 500 grammes weight but I believe the World Health Organisation now recommends 400 grammes as a possible guide to viability.
Stillbirths are registered in Northern Ireland, Scotland, England and Wales and the certificate is prepared by either the doctor or the midwife who attends the birth. In Belgium, Germany and Luxembourg they are registered on the deaths register. There is a special register in France for all stillbirths of over 24 weeks gestation. In Italy the registration of all births, including stillbirths is compulsory within ten days of the birth. The Netherlands has a special register for births and the distinction between a live or dead child at birth is not made; instead it is noted if the child is dead or alive at the time of registration. Denmark makes no distinction between live and stillbirths and the parents can receive a birth and a death certificate for the child.
In addition to the strong social reasons for having a stillbirths register, there are scientific ones. Our medical statistics are excellent but in this area there is a deficiency and I urge the Minister to rectify it.
