As part of the recent Budget announcement, it was revealed that $26.2m will be invested in a new national network of perinatal mental health and wellbeing centres, and $13.9m will help support families bereaved by stillbirth. The RCPA welcomes this focus on perinatal pathology which builds upon the Government’s commitment to reduce the number of stillbirths by 20% by 2025 through a $1.8 million* investment to increase the number of perinatal autopsies.

Dr Diane Payton, Chair of the RCPA’s Paediatric Pathology Advisory Committee and senior staff pathologist at Royal Brisbane and Women's Hospital, explains that this funding will help support thousands of Australians.

“It is a very positive step forward to see a funding focus on stillbirths. Of the $1.8 million investment to increase the number of stillbirth autopsies, $750,000 has been allocated directly to pathology to identify ways to increase the number of perinatal autopsies and number of perinatal pathologists. The value of perinatal pathology cannot be underestimated in order to effectively reduce the number of stillbirths in Australia. An autopsy performed by a perinatal pathologist is the best way to identify and understand the reasons behind these tragic deaths.

“This funding is vital as autopsies for babies who are stillborn are currently not covered under Medicare and each cost approximately AU$4,000. The Medical Services Advisory Committee (MSAC) has advised that the Medicare Benefit Schedule (MBS) is not a suitable mechanism for funding autopsy services, therefore alternative strategies to increase stillbirth investigations are being explored. With increasing evidence that many stillbirths can be prevented, an increase in autopsies will assist in research to prevent further tragedies for many more Australians,” said Dr Payton.

In Australia, there are six stillbirths each day, affecting more than 2,000 Australian families each year. Fewer than half of these will have an autopsy conducted to shed light on the cause.

“A perinatal autopsy can do several things, including to: identify the cause of death; eliminate possible causes; alleviate parental concerns regarding possible causes (i.e., personal blame); identify the possibility of recurrence; enable intervention to treat potentially recurrent conditions; and identify any other conditions that may impact future pregnancies of the mother, or of the siblings of the baby who died, such as a genetic condition. By preventing the recurrence of stillbirth in just one family we will help to decrease the total number of still births in the population,” said Dr Payton.

Allie Richards and her partner John delivered their son Lenny, stillborn, early in their third trimester.

“Once Lenny arrived, I was in a state, I had a million questions running through my mind. What did this mean, what do I do now, how do I tell my mum and family. The main question though was, why did this happen – he was only 10 or maybe 8 weeks from being born. I have never known anybody to have a baby die. I believed that it couldn't happen to me.

“We decided that an autopsy could help us to not only understand what happened, or if we could have prevented it, but it could also help other people avoid having to go through this tragedy. The autopsy gave me some closure. I knew what had happened. There was nothing I could have done to help him and there was nothing I did to harm him. We are glad that other parents will be able to benefit in the same way we did,” explained Allie.

Part of the funding announced by the Government has been allocated to the RCPA and the Royal Australian and New Zealand College of Radiologists (RANZCR) to support clinicians, including perinatal pathologists and radiologists to increase their capacity to undertake stillbirth investigations and autopsies and ensure that these services are available to bereaved parents who choose to access them.

“Bereaved parents who have lost a baby to stillbirth will benefit from this investment, as it helps ensure they are informed about autopsy and investigation options which are available following stillbirth and will support them to make decisions,” said Dr Payton.

*This was announced as part of the 2021-22 Federal Budget.