If only

A while back, my email address was added to a mailing list for folks associated with First Candle -- the organization that has worked tirelessly to reduce SIDS death and has now "taken on" stillbirth also. They frequently send research updates, which I honestly don't have a lot of time to read. But today, for some reason, I read down to the 7th abstract which was related to decreased fetal movement and stillbirth. I hope it is okay that I share this - I don't know what would restrict me from doing so...

Holm Tveit JV, Saastad E, Stray-Pedersen B, Bordahl PE, Flenady V, Fretts R, Froen JFReduction of late stillbirth with the introduction of fetal movement information and guidelines - a clinical quality improvementBMC Pregnancy Childbirth. 2009 Jul 22;9(1):32. [Epub ahead of print]ABSTRACT: BACKGROUND: Women experiencing decreased fetal movements (DFM) are at increased risk of adverse outcomes, including stillbirth. Fourteen delivery units in Norway registered all cases of DFM in a population-based quality assessment. We found that information to women and management of DFM varied significantly between hospitals. We intended to examine two cohorts of women with DFM before and during two consensus-based interventions aiming to improve care through: 1) written information to women about fetal activity and DFM, including an invitation to monitor fetal movements, 2) guidelines for management of DFM for health-care professionals. METHODS: All singleton third trimester pregnancies presenting with a perception of DFM were registered, and outcomes collected independently at all 14 hospitals. The quality assessment period included April 2005 through October 2005, and the two interventions were implemented from November 2005 through March 2007. The baseline versus intervention cohorts included: 19,407 versus 46,143 births and 1215 versus 3038 women with DFM, respectively. RESULTS: Reports of DFM did not increase during the intervention. The stillbirth rate among women with DFM fell during the intervention: 4.2% vs. 2.4%, (OR 0.51 95% CI 0.32-0.81), and 3.0/1000 versus 2.0/1000 in the overall study population (OR 0.67 95% CI 0.49-0.94). There was no increase in the rates of preterm births, fetal growth restriction, transfers to neonatal care or severe neonatal depression among women with DFM during the intervention. The use of ultrasound in management increased, while additional follow up visits and admissions for induction were reduced. CONCLUSIONS: Improved management of DFM and uniform information to women is associated with fewer stillbirths

If only I had been better educated about kick counting and what can and does go wrong, perhaps we could have saved B.W. before his oxygen supply was totally cut off. If only I had paid more and closer attention. Most days I can survive without pondering those pivotal couple of days before his death/birth and the guilt I still feel. I know in my head that I can't "own" our inability to save him from a blood clot, and really I am thankful for that. I guess I just wish our story was one of those close calls where his movement was decreased but we caught it in time to save his life (and not quite so literally, mine).