A national pregnancy loss group is calling for better public awareness of stillbirths and research into reducing the number that occur in Ireland each year.
"In Ireland, over the last ten years, over 200 babies a year are stillborn," said Keelin O'Donoghue, consultant obstetrician at Cork University Maternity Hospital and leader of the Pregnancy Loss Research Group (PLRG).
"There's a lot more that we could do to reduce those rates," Professor O'Donoghue said.
A stillbirth is defined in Irish law as a baby who is born with no signs of life on or after 23 weeks and/or weighing more than 400g.
"Stillbirths for some reason still seems to be a silent and unacknowledged grief," Prof O'Donoghue said.
"There are a few things that are as devastating than the death of a baby during a pregnancy or during a labour or shortly after birth.
"It's one of the worst outcomes."
She added: "I think historically we would have presented stillbirths as this tragic, unavoidable, rare thing that happened and that's just not the case.
"It is unfortunately a devastating reality for hundreds of people every year.
'I didn't think it was going to happen to me’
Marie Creegan lost her daughter, Liliana, to stillbirth the day before she was due, 20 years ago.
"I had some idea that this [stillbirth] happened.
"I didn't think it was going to happen to me, obviously, and then it did."
Ms Creegan said the pain of a stillbirth was unimaginable.
"Having to go and bring a baby into the world they've already left ... the absolute grief, the sadness, the depth of sadness and the depth of pain - I would never have imagined it," she said.
Several years after Liliana's death, Ms Creegan became one of the co-founders of Féileacáin, a Stillbirth and Neonatal Death Support charity.
Twenty years on from Liliana's death, Ms Creegan said there is now a greater awareness of the care that grieving families need following a stillbirth or neonatal death.
Organisations such as Féileacáin have worked to increase supports for grieving parents. Parents who lose a child are given hospital supports, memory boxes for their child, if they want to bring their baby home they can do so.
Since October 2024, families can choose to record a stillbirth on a public register.
"It's a huge difference, I got very little at the time," Ms Creegan said.
"However, why is it still happening? ... Stillbirth is not being researched, it's not being talked about. We have a fear of discussing stillbirth and I don't know why.
"We need to look at that, it is still a fact of life, and we hope it won't be soon."
She added: "Babies don't die for no reason, they die for reasons we don't know."
Talking about stillbirth
Taking a five-year average, 220 stillbirths occur in Ireland each year.
The average age a woman has a stillbirth in Ireland is 31.7 years.
Prof O’Donoghue said that the first step is talking to expectant parents and making it clear that stillbirth is something that can happen.
"If we don't talk about it, it's not seen as a possible outcome in pregnancy," she said.
"And that lack of public discussion and societal awareness means that we're not helping prevent stillbirths by not talking about it."
Although not every stillbirth can be prevented, Prof O'Donoghue said that many are potentially preventable.
"In Ireland, we know that if stillbirths are fully investigated, we will find a cause as to why that happened in 90-95% of cases.
"Around one third of stillbirths happen at or very close to term and we know from those causes of death that many are preventable.
Prof O'Donoghue said: "There are public health informational pieces that we could improve around how women are aware of those risks during pregnancy.
"We do need to do more to help women and healthcare professionals have those conversations all the way through antenatal care.
"There's no doubt that we as healthcare professionals in our regular practice can be quite uncomfortable talking about outcomes like stillbirth and we fear we're going to upset pregnant women."
Research carried out by the PLRG, as well as international studies, show that women welcome conversations around stillbirth as long as they are delivered appropriately.
Ireland ranks 20th out of 24 countries in Europe for perinatal deaths (the combined name for stillbirths and early neonatal deaths).
The PRLG is advising a cross-party Oireachtas group that has been established on pregnancy and infant loss.
"Our aim is to present policymakers with a factual list of what can be done," Prof O'Donoghue said.
One of the areas the PLRG is focusing on is on ending preventable baby deaths and it is working on an action plan to present to the cross-party group in the spring.
"If you ask me, are stillbirths preventable? I will say yes, they are," Prof O'Donoghue said.
"By putting together an action plan that encompasses public awareness, risk and communication in pregnancy, looking at how to provide best care to every woman in pregnancy each time, continuous care improvement, learning from the deaths that do occur and then prioritising research."
She added: "It's important that we look at all of those baby deaths together because improvements that we make will improve outcomes for all pregnancies and could reduce all types of baby deaths."
