Of all the little moments of joy and strife that fill the high-profile Oscar movie "Roma", the worst moments take place in a hospital room in Mexico City, where a doctor tells a frightened young woman cool baby was dead born. "
The haunting scene from 1971 graphically introduces a theme that is still poorly understood and often avoided. While global interest rates have since declined, stillbirths are surprisingly high at nearly 3 million a year, most of them in developing countries.
The US quota (6 out of 1,000 births) has not changed for a decade and the cause is unknown at least one-third of cases. Most US insurers do not cover autopsies and many parents do not want them, often leaving behind circumstances and possible causes.
"This is a really seriously understaffed area of research," said Jennita Reefhuis of the US Centers for Disease Control and Prevention. "It's such a devastating event that happens to a couple. This deserves a bit more attention. "
Lindsey Schmitz looks out of her home in Chicago. In 2016, Schmitz gave birth to a stillborn son, Sawyer, after a schoolbook pregnancy
Rebekah Shirey and her partner Steve Martin with their stillborn Elijah in a hospital in Ottawa, Canada. Shirey had learned days ago that Elijah's heart had stopped beating.
Stillbirth in Roma, the Oscar-nominated film. The doctors do not allow the housekeeper Cleo, played by Yalitza Aparicio, to be with the baby at all times before it is washed away
The young mother in Roma only has a few seconds to keep her lifeless child before a doctor tells her that he has to take the body and "prepare". From her hospital bed, a few feet away, she watches in silence as the baby is wrapped in a white cloth.
The coldness of this lingering scene is sometimes dramatic, but it also reflects thought at the time when the stillbirths almost depended on being rejected. Francisco Ruiloba, an obstetrician from Mexico City, said that many hospitals in Mexico and elsewhere have adopted a more humanistic approach. In his practice, Ruiloba says, mothers are given as much time as they need and the body is prepared "with respect and out of the room".
Last year, the guidelines reaffirmed that the American College of Obstetricians and Gynecologists referred to this as emotional. Parents of stillbirths should be offered support, including referrals to grief counselors, support groups, or therapists. Parents should have a chance to hold and name their babies, and to say goodbye, the group advises.
Studies have found that parents' ability to spend time with stillborn infants may reduce their chances of developing anxiety and depression afterwards. Many US hospitals allow parents to spend hours or even days with them. Some hospitals take souvenir photos, footprints and handprints for families. Some provide cooling beds to protect the body while the family mourns.
We stress how important it is for the patient that we make ourselves comfortable talking to them and talking about this being a terrible thing, but they will do it, "said Dr Alan Peaceman, Head of Department of Mother-Fetal Medicine, Northwestern Medicine, Chicago.
Pediatrician Lindsey Wimmer, whose son Garrett was born dead in 2004, says parents said they should not see anything her baby, just to go on and have another, now we know that this is not a very practical way to deal with it.
"Their grief is just waiting for them and they will never forget these babies," said Wimmer, Managing director of the Star Legacy Foundation, a Minnesota-based group that promotes stillbirth research and education.
Schmitz holds a framed photograph of her stillborn son Sawyer, who was cuddled in her home in Chicago by her and her husband Andrew. He was warm. He was beautiful and had smelled this baby. He just looked like he was asleep. & # 39 ;, recalls Lindsey
Lindsey Schmitz's home décor in Chicago's home is dedicated to her young daughter and her son Sawyer
. Social media has given saddened parents a new paragraph. Canadian Rebekah Shirey has posted a moving video for friends that looks almost like a routine job. Surrounded by family and friends in an Ottawa hospital room with her partner Steve Martin at her side, she pushes, cries and cradles her stillborn son Elijah. It was July 29, 2017, and Shirey had learned days ago that Elijah's heart had stopped beating. Tests showed problems with their placenta.
"The more awareness we have and the more community we have, the easier it is going to be through these things," she said.
SCIENCE & ADVOCACY: WOMEN TO MEET BABIES 'KICKS IN THE THIRD TRIMESTER TO SPOT SIGNS OF A PROBLEM
US physicians define stillbirths as fetal deaths after 20 weeks gestation; In many other countries it is 28 weeks or later. Because there is no national registry in the US in many countries, and although fetal deaths are reported in every state, the documents often contain minimal information.
About 1 percent of pregnancies in the US end in stillbirth, or nearly 24,000 a year. Obesity, diabetes, smoking and getting pregnant after the age of 35 increase the risk, and the rate is twice as high in black women than in whites.
Placental problems contribute to about one in three stillbirths in industrialized countries. As part of the US Government's Human Placental Project, researchers are seeking better ways to detect placental problems, including imaging and blood tests.
Many hospitals in Mexico and elsewhere have since adopted a more humanistic approach, leaving the mother with more time with her baby. But back then, when Roma was hired, this was not the case.
Recent studies have provided new evidence suggesting that stillbirths with reduced or excessive movements of the fetus, women sleeping on their backs during late pregnancy, contribute to high temperatures and excessive air pollution. In one study, it was even found that in women with stillbirths, a "belly instinct", where pregnancy had gone awry, was more common than with other mothers.
Doctors advise women to focus on fetal movement late in pregnancy and to be aware of any changes that may indicate fetal discomfort. Childbirth induction is an option when pregnancy has progressed well enough, and some studies suggest that kick-counting may reduce the stillbirth rate.
Several Ivy birth mothers have launched a campaign to encourage women to count public-accepted kicks to health authorities in six states. In Iowa, where it was adopted in 2008, the stillbirth rate has fallen below 5 in 1,000. Although there is no evidence, Kimberly Piper, a nurse and a State Department of Health official, said the campaign may have contributed to the decline.
Approximately 1 in 5 US stillbirths occur at the end of a normal, uneventful pregnancy. The scenarios are very similar: a few days or weeks before the due date, a woman suddenly realizes that she has less kicks or no movement of the fetus. Most women want an immediate caesarean but these surgeries are rarely performed for stillbirths because of the risks. Instead, doctors give medications to induce labor, and parents wait.
On the wall of Lindsey Schmitz in Chicago is a souvenir box for the dying Sawyer Schmitz. She says that she is plagued by things she did not think she was doing in her grief. "He cut off a strand of hair, read him a book, we never put it on. At that moment you just do not know that you will want that. # 19659028] This is the nightmare that Lindsey Schmitz from Chicago 2016 after a & # 39; Textbook & # 39; pregnancy had to endure. After 24 hours of hard work, the nurses gently placed Sawyer Schmitz on his mother's chest and stepped away as the force of that moment sank.
"He was warm. He was beautiful and smelled that baby, "Schmitz recalls. "He just looked like he was sleeping."
Grandparents, aunts and uncles joined the desperate parents in the birthing room.
"They commented on his features, laughing at his chin," she said. "The nurses took pictures, lots of pictures."
Schmitz says she's plagued by things they do not do in their grief "Cut off a strand of hair, read a book to him, we've never dressed in. At this moment, you just do not know what you want."
She wanted to know the cause, but an autopsy and other tests did not provide any answers ,
Well, volunteers of aids for other women who had stillbirths.
"When you're in this club, you find it's so much more common than anyone is talking about," she said.