Stillbirth Clinical Care Standard
The Commission is developing a Stillbirth Clinical Care Standard to improve the appropriateness of care for stillbirth prevention, and the quality of bereavement care following perinatal loss.
Background
In December 2020 the Federal Minister for Health, the Hon. Greg Hunt MP, released the National Stillbirth Action and Implementation Plan (NSAIP) which aims to reduce rates of preventable stillbirth (after 28 weeks gestation) by 20% by December 2025. It also aims to ensure that, when stillbirth occurs, families receive respectful and supportive bereavement care.
The development of a national clinical care standard for stillbirth is described in the NSAIP within ‘Action area 7 - Developing and implementing a national evidence-based, culturally safe stillbirth education program for health professionals’. The NSAIP proposes that the Standard should support health professionals to provide optimal, evidence-based care to improve outcomes for women and families. The Department has provided funding to the Commission to support the development of this Standard.
The NSAIP outlines 14 action areas, and is available at www.health.gov.au/maternity
Development of a clinical care standard for stillbirth prevention and bereavement care
This clinical care standard aims to reduce unwarranted variation and improve the appropriateness of care for stillbirth prevention, and the quality of bereavement care following perinatal loss. The standard will also support the delivery of evidence-based clinical care, and promote shared decision making between patients, carers and clinicians.
The clinical care standard will reflect current best practice and guidelines on stillbirth prevention and management, including the Clinical Practice Guideline for Care around Stillbirth and Neonatal
Death1, the Clinical Practice Guidelines: Pregnancy Care 2 and the Safer Baby Bundle 3.
The Commission will also take into account the findings of the Fourth Australian Atlas of Healthcare Variation 4 - which reported high rates of planned caesarean section births performed before 39 weeks (2017 figures) without a medical or obstetric reason - in order to avoid any unintended consequences on early planned birth rates.5
The Stillbirth Clinical Care Standard Topic Working Group
The Commission has established a Stillbirth Clinical Care Standard Topic Working Group (TWG) with expertise from relevant clinical specialities including obstetrics, general practice, midwifery, neonatology, sonography, bereavement care and rural and remote medicine from states and territories around Australia.
The main roles of the group are to:
- Provide expert advice on the development of the Stillbirth Clinical Care Standard and related guidance materials
- Provide ongoing guidance on the impact of the Standard on key stakeholders
- Acknowledge and take into account the perspectives of a broad range of stakeholders when providing advice to the Commission
- Consider advice, as required, from the National Stillbirth Implementation Oversight Group
- Advise the Commission on the scope and key components of care to be the focus of the Standard
- Advise the Commission on the key sources of evidence to inform the development of the Standard. This might include clinical practice guidelines, clinical standards, systematic reviews and meta-analyses
- Advise on the formulation of quality statements and supporting indicators
- Present potential strategies to the Commission that support the implementation of the Standard
- Actively support raising awareness of the Standard
- Advise the Commission on a review plan for the Standard, and support any associated revision as required
- Actively support consultation on new resources developed
- Provide advice on communication strategies to support new resources
For those who are consumers, a key role is to advise the Commission on matters relating to their experience - whether as a patient or carer - and provide this perspective during the development of the Standard.
All topic working group members are required to disclose financial, personal and professional interests that could, or could be perceived to, influence a decision made, or advice given to the Commission. Disclosures are managed in line with the Commission’s Policy on Disclosure of Interests.
Public consultation
Consultation on the Stillbirth Clinical Care Standard was conducted from Monday 7 February and closed on Monday 14 March 2022.
Following public consultation, the Commission will review all comments and use this analysis to finalise the draft clinical care standard.
Next Steps
A high-level summary of the activities and timeframes to deliver this clinical care standard is provided in the table below.
| Activity | Timeframes 2021-2022 |
|---|---|
| Project planning and knowledge acquisition, including guideline review and key informant interviews | June – September 2021 |
| Establish Topic Working Group (TWG) | September 2021 |
| Meetings with TWG to define scope and reach agreement on quality statements | September – December 2021 |
| National consultation | January – March 2022 |
| Post-consultation analysis and amendments | March – May 2022 |
| Approvals and endorsement processes | June – August 2022 |
| Stillbirth Clinical Care Standard launch | October 2022 |
Contact us
If you have any questions about the Stillbirth Clinical Care Standard, please email ccs@safetyandquality.gov.au
For future updates on Standards due to be launched and out for consultation, follow us on Twitter @ACSQHC or subscribe to our eNewsletters.
References
- Clinical Practice Guideline for Care around Stillbirth and Neonatal Death https://sanda.psanz.com.au/clinical-practice/clinical-guidelines/
- Clinical Practice Guidelines: Pregnancy Care (2020) https://www.health.gov.au/resources/collections/pregnancy-care-guidelines-and-related-documents
- Safer Baby Bundle https://stillbirthcre.org.au/about-us/our-work/the-safer-baby-bundle/
- The Fourth Australian Atlas of Healthcare Variation - Chapter 1 (2021) https://www.safetyandquality.gov.au/sites/default/files/2021-04/fourth_atlas_2021_-_chapter_1._early_planned_births.pdf
- Selvaratnam R, Davey MA, Wallace EM. Reducing stillbirth safely in Australia. The Medical Journal of Australia. 2020 Jun 22;213(1):9-9.e1.