What Hospitals Do with Stillborn Babies in South Africa
What is a Stillborn Baby in South Africa?
A fresh stillbirth is defined as the intrauterine death of a fetus during labor or delivery; while a macerated stillbirth was defined as an intrauterine death of a fetus occurring before the onset of labor and the fetus shows degenerative changes.
What does the Law says about Stillborn Babies management in South Africa?
The common-law crime of ‘exposing’ an infant is the unlawful and intentional exposure and abandonment of a liveborn infant in circumstances that are likely to lead to its death. Prosecutions are rare, and if prosecution is pursued, individuals are usually charged with murder. However, the crime of murder can only be committed against a ‘person’, i.e. one who is born alive. According to section 239(1) of the Criminal Procedure Act 51 of 1977, breathing is sufficient evidence of live birth for purposes of criminal prosecution.
What is the cause of stillbirth in South Africa?
Between Oct 9, 2014, and Nov 8, 2015, around 354 stillbirths (born to 350 women) were enrolled. Among the women with available data, 133 (38%) of 350 had hypertension, median age was 27 years (IQR 23–33), 51 (18%) of 291 were obese, six (2%) of 344 had syphilis, and 94 (27%) of 350 had HIV. 63 (18%) of 341 fetuses showed intrauterine growth restriction. Of 298 cases (born to 294 mothers) with complete samples, the most common causes of stillbirth were maternal medical conditions (64 [21%] cases; among them 56 [19%] with hypertensive disorders and six [2%] with diabetes), placental or fetal infections (58 [19%]; 47 [16%] with fetal invasive bacterial infection), pathological placental conditions (57 [19%]; among them 27 [9%] with fetal membrane and placental inflammation and 26 [9%] with circulatory abnormalities), and clinical obstetric complications (54 [18%]; 45 [15%] with placental abruption). Six (2%) stillbirths were attributed to fetal, genetic, or structural abnormalities. In 55 (18%) cases, no cause of death was identified. The most common bacteria to which stillbirths due to fetal invasive infections were attributed were group B streptococcus (15 [5%] cases), E coli (12 [4%]), E faecalis (six [2%]), and S aureus (five [2%]).
What do Hospitals Do with Stillborn Babies in South Africa?
The law states a foetus meeting with death before 26 weeks intra uterine may not be buried but should be disposed of as medical waste. This is in sharp contrast to the law which stipulates that a woman may no longer terminate her pregnancy ‘on demand’ once 20 weeks of gestation has been reached and may do so only for medical and other specified reasons after 20 weeks of pregnancy.
