Stamp Out S.A.D.S.

We’ve all heard about SIDS – the sudden unexplained death of babies in their cribs that occur for no determinable medical reason. In 2000, there were 2,181 SIDS deaths reported in the United States. That year there were over 26,000 S.A.D.S. deaths reported, almost 12 times as many.

S.A.D.S. stands for Sudden Antenatal Death Syndrome, better known by the familiar term, stillbirth. Medically speaking, stillbirth is the death of a baby in its mother’s womb, after 20 weeks gestational age and up to the moment of delivery, which is when many die…. at the “finish line”!

Stillbirth is unpredictable and random, and often strikes like lightening in a thunderstorm. There is no way to know if or when or where it will strike next. The reason it is unpredictable is because half to two-thirds of all stillbirths occur for indeterminable reasons, and cannot be attributed to a specific identifiable medical cause.

Because of its randomness, and the lack of any warning, stillbirth, is said to be "An Equal Opportunity Destroyer of Dreams". It cuts across socio-economic classes, races, religions, body types and maternal age groups. No woman is immune from this "last great mystery of obstetrics". Even women who have had several successful prior births can experience a subsequent stillbirth.

That so many stillbirths occur at or near late term - when the developing baby is well beyond the point of viability and could survive outside the womb - is especially devastating, leading mothers and their doctors to speculate what might have been had their baby been delivered earlier.

Autopsies, when performed, rarely uncover any cause of stillbirth not already apparent from a physical examination of the baby and placenta.

There is no uniform stillbirth post-mortem (autopsy) protocol in use today anywhere in America. Every autopsy is done according to local practice. Because of that there is no uniform data available for analysis.

When a post-mortem procedure is performed, it is rare for the mother to be interviewed, in spite of the fact she may have vital clues to her baby's cause of death. A uniform protocol would address this shortcoming.

There is no centralized repository for autopsy data that could permit the analysis and comparison of results, if and when an autopsy is performed. Imagine the chaos if police kept fingerprint cards in each department's file cabinet. Crimes would never be solved, just as stillbirth isn't being solved because the data - when autopsies are performed - is not made available to researchers but kept at each hospital, if kept at all.

Used with author’s permission. Copyright Richard K Olsen, President of the National Stillbirth Society