House of Assembly - Fifty-Fifth Parliament, First Session (55-1)
2024-10-31 Daily Xml

Contents

Motions

Stillbirth

Ms SAVVAS (Newland) (11:02): I move:

That this house establish a select committee to investigate and report on stillbirth in South Australia and its prevention, specifically—

(a) best practice stillbirth prevention education and awareness programs for expectant parents; including, but not exclusive to, the monitoring of babies in utero;

(b) public education programs/initiatives to increase community awareness of stillbirth and where people can access support in the community;

(c) models of care in pregnancy that may contribute to a reduction in stillbirth (including for priority populations);

(d) models for follow-on care (including mental health support or care in subsequent pregnancies) for parents after stillbirth (and infant loss more generally);

(e) support and training for healthcare professionals relating to stillbirth prevention and bereavement care;

(f) best practice regarding stillbirth investigations (including access, information for parents and case review), pathologist training and service provision;

(g) processes of data collection, reporting and monitoring;

(h) allocation of research effort; and

(i) any other related matters.

I will speak very briefly today about the introduction of this committee to the house. As many would know, because I have spoken many times in this place about this matter before, it is of course a matter that is incredibly close to my own heart having lost my own little brother to stillbirth when I was four.

I think that today is a particularly important day to be introducing this committee, on the final day of Pregnancy and Infant Loss Awareness Month—31 October. It is a really important month for families not only to spread awareness and education about pregnancy and infant loss but also, of course, to break the stigma around having conversations about pregnancy and infant loss. In my own personal experience, whether it be here in this place or just out and about in the community, I have made it a personal goal of mine to do what I can to break that stigma and to have those open and honest conversations that for many generations have not been had, generally because it has been seen as women's business or issues relating to women's health—which, we all know, are not often spoken about or have not been spoken about historically.

Despite the numbers—and there are six babies born still in Australia every day, a number higher than the national road toll—there is still stigma around talking about stillbirth, and I think that is incredibly unfortunate. When I think about that figure, I think back on the fact that it was only a generation or two generations ago when parents and grandparents and family members were not given the opportunity to officially name their babies. They were not given the opportunity to give their babies a final resting place, a place where families can go and grieve and remember those babies lost and loved. I think that is incredibly sad and it has actually added, for many generations, to the complex grief that parents and family members experience as a result of pregnancy and infant loss.

Of course, we have come a very long way, and it would be remiss of me not to acknowledge the tireless efforts of former Senator and former Premier of New South Wales Kristina Keneally, who has been an advocate for stillbirth awareness and education for many years after the loss of her daughter, Caroline. I went to a function on Friday night, the Still Aware Gala. Still Aware is Australia's first stillbirth charity based here in SA, set up by the Foord and Heath families after the stillbirth of little Alfie some years ago. Kristina was the guest speaker that evening, and she talked about the fact that as someone who was highly educated and not from a low SES area, she did not actually know that something like that could happen to her.

Unfortunately, I think it is often the case that individuals do not realise that they could be facing or experiencing a pregnancy loss or a stillbirth until it happens to them. I think that is a real problem. We need to be talking about education and awareness, particularly in utero. The Still Aware foundation have done a really incredible job of increasing that awareness, including doing some tailored programs for educating mums in Aboriginal and Torres Strait Islander communities, which has been really important. We know that, unfortunately, the rates in Aboriginal and Torres Strait Islander communities of stillbirth and pregnancy loss more generally are much higher than those of non-Aboriginal and Torres Strait Islander communities.

I want to commend the work of Jane Warland, who has been running the WINDS project with Still Aware to create those educational pieces not just for those communities but alongside those communities; I believe they refer to it as 'for mob, with mob'. The way that that has been designed has been so important in terms of increasing awareness in places where those conversations have not been had in the past.

This morning, I had the really wonderful opportunity of going to the women's and kids' with Minister Picton and meeting with some individuals who have been involved in the Wattle Clinic. The Wattle Clinic has been set up this year at the women's and kids' to support families who are experiencing another pregnancy after the devastating loss of a child. So far, since January, the Wattle Clinic has seen 29 families through their pregnancies with that really important continuity of care and follow-up care after what was obviously an incredibly traumatic experience for those families. There are another 10 pregnant families who are going through the Wattle Clinic at the moment as well.

We were really blessed to have a family there with us: Demian, Hayley and baby Bodhi, who is three months old. They shared with us their experiences of going through the Wattle Clinic to bring Bodhi safely into the world after their firstborn baby, Zen, was stillborn. It was such an incredible story to hear from them but also a pretty emotional moment for me returning to the women's and kids'. I have not spent a lot of time at the women's and kids' as an adult, I will tell you, but when I was little we were there all the time.

After the stillbirth of my baby brother Ben at the women's and kids', my mum spent almost the entirety of the following two pregnancies living at the women's and kids' to make sure that she was supported through those subsequent pregnancies, my little brothers Zach and Elijah. There was a craft room that mum spent many a day in. She would knit, she would make moneyboxes, she would make photo frames—we still have them all around the house—and we would go and visit after school and on weekends. Mum spent the really important months of those pregnancies supported by the women's and kids', and they do such incredible work there.

It was not a tailored program, of course, like the Wattle Clinic is, to support those pregnancies after loss and I do see personally just so much value in that. I also see a lot of value in the way that they are going about it with students. We met a student today, Francesca, who is a midwifery student at UniSA and talked about what it means for our next generation of midwives to not just be learning about the happy moments, the science behind a pregnancy, but, of course, to experience firsthand what it is like to be alongside a family when they do have a significant bereavement, that loss that is so difficult for families, and what it means for our midwives to actually understand that before they go out into practice themselves.

I was really warmed to be there this morning to share a bit of my personal family's story and, of course, to do so in the memory of my little brother and in memory of all the babies who have been born still, and the families, of course, who mourn those babies and have mourned those babies for a very long time. I talk a lot about how it never really leaves you and I know that for our family the impacts have been significant.

But even talking about those pregnancies with my two younger brothers and those experiences—me as a little kid running through the hospital and my mum going through a pregnancy in a hospital setting where everybody else was bringing home a baby—is something that we need to talk about, something we need to acknowledge, and how those experiences can be for bereaved families.

Since talking about it and speaking in this place and at other functions about pregnancy and infant loss awareness, I have been so privileged, so humbled to have so many parents contact me sharing their stories. I do want to particularly acknowledge one family who came to speak to me just last week and gifted me a photo of their little boy who was born still as a token of appreciation for speaking up about this topic. Again, what that means to be brought into those people's lives, to be given the great privilege of knowing the story of their baby who they miss and they love so dearly, really meant a lot to me and I know that this sort of work is going to mean a lot to families.

Because, of course, although I had the great privilege of growing up knowing that I had a little brother and I was brought up in a family where we talked about those things—we had his footprints in the house, we had a portrait of him in the house—I know that not everyone has been and that not everyone necessarily has been given the tools or the skills to have those conversations out loud. So it means a lot to me and it means a lot to families like mine to have those conversations, to be a voice for those who do not feel that they can share their experiences.

In acknowledgement of that, I do want to outline and acknowledge that I know in the process of bringing in this committee there will be a lot of people who find it really hard to talk and there will be a lot of people who talk for the very first time, and I think that that is again so important. It should be a fundamental business of governments to listen to individuals, particularly individuals who are going through difficult times like this one. I want to thank all of those individuals in advance who are going to share their stories with us in what can be an incredibly difficult thing to talk about. I know a number of people who have lost babies and still struggle to have those conversations.

I do think, of course, it is important that the states do so. I mentioned Kristina Keneally and her work before. She has been instrumental in stillbirth awareness in this country and was pivotal in the federal inquiry into stillbirth. But she has acknowledged—and does acknowledge quite openly—and has said to me as well, that where there was a gap in what they did was what they can do in a public hospital setting.

Of course, that is the purview of state governments and what she encouraged us to really focus on were those bereavement supports in a hospital setting in the minutes, hours, days, months and years following a pregnancy loss, because that hospital is often the touchpoint. It is obviously not just where the baby is born and the baby is lost, but it is also the place where parents will continue their fertility journeys, returning to the hospital with all of those anxieties, the questions about whether it be the genetics of what has occurred, or even just the mental health element, which is so important if you are deciding to continue the growth of your family.

So it is really important that the states do take on some of that work and I do want to acknowledge a few people who have been really instrumental in getting this to be what it is today. I have spent the last few years meeting with a number of bereaved parents, families and advocates. I want to thank Still Aware who have been such brilliant advocates in this space for 10 years now, not just here in South Australia but around the country. I want to thank some individuals from the Women's and Children's Hospital. Our terms have been supported by Christopher Barnett and Rebecca Smith, both experts in the hospital setting, who have really advised and provided some information on this.

Of course, I want to thank all my colleagues who really supported this mission of mine. It is one that I take very seriously and one I care about very much. I also want to thank all the parents who have spoken and who want to see change in this area. It has always been important for us as a family to say this: I see those parents with lost babies, I value their lost babies and our family continues to grieve with those who have lost their babies as well.

I am very proud to be moving this today on behalf of my baby brother, on behalf of my mum and, of course, all others who have babies lost and loved.

The Hon. D.G. PISONI (Unley) (11:15): I rise to support the motion and speak briefly on the select committee process. I have had quite a bit of experience on select committees in my 18½ years in this place and there is nothing more satisfying than when a select committee is timely and when a select committee delivers a bipartisan move for change.

There is no doubt that the member for Frome and I, on this side of the chamber, were very pleased with the work that we did with the committee chaired by the member for Badcoe on the dispensing of treatment for UTIs via pharmacists. I think that report was an example of where there was a strong indication to the minister of the bipartisan support of what was a controversial move. It was a move that was about enabling people to go directly to a pharmacist to be diagnosed and to be —'prescribed' is not the right word because the pharmacists are not prescribing the antibiotic—dispensed the antibiotic after establishing that there was a very good chance the ailment the patient was suffering from was a UTI, and in most instances that gave immediate relief.

What was important from that committee was that there was an understanding that pharmacists knew that there would be a provision that the patient also see their doctor after they had that initial medicine. This was an important move for women, in particular—it is not available to men because even if a man has a UTI it is normally a much more complex issue than if a woman has a UTI—because it meant that immediate relief could be sought while perhaps a longer term treatment could be offered by the GP.

The problem that women were having was that for something that needed instant relief sometimes there was a one or two-week period to wait to get into a GP, in which case the situation would get worse or it would heal over a five or six-day period and that person was in pain they did not need to be in.

One of the things that was successful about that select committee was that not only did we hear about women's experiences of access to antibiotics and the difficulty they were having in getting those appointments and the cost, the gap charges of course, with seeing GPs, we also heard an enormous amount of evidence delivered by practitioners in Queensland, for example, who were already offering a trial and a lot of evidence from science about why it was safe for pharmacists to move down this track because, of course, there was an opposing view from the Royal Australian College of General Practitioners and from the medical practitioners on this issue.

Because the committee spent an enormous amount of time getting to understand the science and the reasons why this process with pharmacies would not compromise health, we were in a very strong position to put forward, in a bipartisan manner, a very strong recommendation for the health minister to consider. Of course, we know now that this service is available in South Australia. It is one of the quickest responses to a select committee or any committee that I have ever experienced in this place.

The member for Finniss and I will certainly be very keen to participate in this process. We are very keen to learn about best practices in stillbirth prevention, awareness and programs for expectant parents. I think what you learn about being a parent yourself is that sometimes it is even a bit late once you are already pregnant to be looking at how you can reduce the risk of something happening to the foetus. Families are not always planned but, when they are, there are things you can do prior to pregnancy that could possibly minimise the risk of a stillbirth.

I would be very interested in hearing about what is happening in that space and what research has been done and what has been planned. How much research is being done? I think the process of data collection, reporting and monitoring is very important because you cannot manage what you do not measure. I think through this committee we will get an understanding from those in the medical profession who deal with women who have experienced stillbirth or who know that they are going to have a stillbirth—understanding how that data is collected, how it is analysed and how that may help with the science in reduction or prevention of stillbirth in the future.

Models of care in pregnancy may contribute to a reduction in stillbirths, including different groups in the community. Certainly in health it is not a one-size-fits-all, and in women's health it is even broader when it comes to the known unknowns and the unknown unknowns in some health issues that women have that men never really have to be concerned about for themselves but obviously are concerned about for their partners and their children.

In supporting this motion I wish the Chair all the best in delivering an outcome to this parliament and to the minister that will see an action by the government that will make a lasting difference to those women and those families who have or will experience stillbirth in their lifetime.

Ms SAVVAS (Newland) (11:23): I want to thank the member for Unley for his comments. I am really glad that we are going to have the member for Unley and the member for Finniss on our committee. I spoke at the hospital again this morning about how I think that this issue has not been discussed for many years because it was considered to be simply a women's issue, so I think it is really important to have the perspective of men on our committee. I think that is actually incredibly important because for many, many years those discussions have not been had and it is, of course, something that affects mothers, fathers, siblings and family members, and that is a really important perspective. I am really pleased to have them both joining our committee and pleased to be having the rest of our membership as well. In a moment, I will move that they join us.

Motion carried.

Ms SAVVAS: I move:

That a committee be appointed consisting of Mr Basham, Ms Hood, the Hon. D.G. Pisoni, Ms Wortley and myself.

Motion carried.

Ms SAVVAS: I move:

That the committee have power to send for persons, papers and records and to adjourn from place to place and that it report on 28 November 2024.

I do note that is a very close date, but we will be returning to the house to adjust that date once we have a sitting calendar for 2025.

Motion carried.