In Australia each year, around 3,000 families experience a stillbirth or the loss of a newborn baby.
Despite advances in medicine, Monash Health resident medical officer Dr Keeth Mayakaduwage says stillbirth rates have remained unacceptably high, especially in marginalised communities.
‘One of the biggest challenges in stillbirth prevention is the lack of awareness and education. Many people are unaware that a significant number of stillbirths are preventable through improved antenatal care measures, such as smoking cessation, better detection and management of fetal growth restriction and decreased fetal movement, safe maternal sleeping practices, and appropriate timing of birth.
‘Furthermore, disparities in access to quality healthcare, particularly for women from marginalised communities, create significant obstacles to reducing stillbirths. Overcoming these barriers requires a multifaceted approach that includes targeted policies, equitable resource distribution, and comprehensive education efforts,’ Dr Mayakaduwage says.
Through his research, teaching, and advocacy, Dr Mayakaduwage, who is also an adjunct lecturer in Obstetrics and Gynaecology at Monash University, strives to enhance stillbirth prevention and ensure that all women, regardless of their background, have access to high-quality antenatal care.
This led him to focus his research on understanding the causes of stillbirth and identifying effective, evidence-based interventions.
His work has been centred on the Safer Baby Bundle, an evidence-based antenatal care initiative that aims to reduce preventable stillbirths.
Developed by the Centre of Research Excellence in Stillbirth and first launched in Victoria in June 2019, this bundle provides crucial guidance to improve outcomes in maternity care.
Dr Mayakaduwage led the evaluation of its implementation in Victoria, demonstrating its effectiveness in reducing stillbirths. The bundle, along with culturally adapted versions designed for Indigenous and migrant women, is now being rolled out nationwide, with the potential to significantly lower stillbirth rates across Australia.
He points out that the directors of the Centre of Research Excellence in Stillbirth, Professor Vicki Flenady AM and Professor David Ellwood AO, were instrumental in creating and implementing the Safer Baby Bundle. Additionally, Associate Professor Miranda Davies-Tuck, who is his supervisor for the Victorian evaluation of the Safer Baby Bundle, provided invaluable guidance throughout the project.
Dr Mayakaduwage is currently leading the International Survey of Perinatal Death Education among healthcare students and providers, in collaboration with Monash University and the International Stillbirth Alliance. This project aims to assess the preparedness of healthcare students and junior clinicians to care for parents who have experienced perinatal death.
The survey targets final-year medical, nursing, and midwifery students and graduates within the last five years to understand gaps in education and training. This project addresses the urgent need for better training in bereavement care, which is often overlooked in healthcare curricula.
‘This research could have a lasting impact on how we train healthcare providers,’ he says.
Any eligible students or graduates are welcome to help improve care in this area by filling in the survey here.
Looking ahead, Dr Mayakaduwage envisions a future where stillbirth rates are reduced, and no family has to endure the preventable loss of their baby.
“This will require a global effort to increase research funding, improve healthcare education, and ensure that all women—regardless of their socioeconomic or cultural background—have access to comprehensive antenatal care.
“I also hope to see more collaborative efforts between healthcare providers, policymakers, and community leaders to prevent stillbirth,” he says.
Dr Mayakaduwage is the recipient of the 2024 Public Health Association of Australia (PHAA) Emerging Leader Award. He also received the Australian Medical Association’s (AMA) Women’s Health Award for his contributions to improving stillbirth prevention and antenatal care.
October is recognised globally as Pregnancy and Infant Loss Awareness Month. It is a time for families, communities, and healthcare professionals to come together to break the silence surrounding miscarriage, stillbirth, and infant death.