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Healthcare and wider societal implications of stillbirth: a population-based cost of illness study

Plain language summary from BJOG's Stillbirth themed issue
Read the full study

 

Why and how was the study carried out?

The personal, social, and emotional consequences of stillbirth are profound. Placing a monetary value on such consequences is emotive, yet necessary, when deciding how best to invest limited healthcare resources. We estimated average costs associated with a single stillbirth and costs for all stillbirths occurring in the UK over a one-year period.

 

What were the main findings?

The average cost to the NHS of care related to the stillbirth and a first subsequent pregnancy was £4,020 for each stillbirth. For the UK, this cost was £13.1 million annually.

Clinical negligence payments to bereaved parents were estimated at £2.5 million per year. Parents were estimated to spend £1.8 million per year on funerals.

The cost of workplace absence as parents cope with the effects of grief was estimated at £2,476 per stillbirth. For the UK, this cost was £8.1 million annually.

The loss of a baby is also the loss of an individual with the potential to become a valued and productive member of society. The expected value of an adult’s lifetime working hours was taken as an estimate of this productivity loss and was £213,304 for each stillbirth. The annual cost for all stillbirths was £694 million. We know from parents that the birth of a subsequent child in no way replaces a stillborn baby. We found that 52% of women fall pregnant within 12-months of a stillbirth. From a purely economic perspective concerned only with the number of individuals in society, babies born during this period could potentially replace the productivity losses of the stillborn baby. Adopting this approach, which we understand is controversial and difficult for bereaved parents, expected productivity losses would be lower at £333 million.

 

What are the limitations of the work?

For some categories, existing data were unavailable and we used clinical opinion to estimate costs. Further, we were unable to quantify some indirect consequences, for example the psychological distress for wider family members.

 

What is the implication for parents?

Placing a monetary value on what is for parents a profound personal tragedy may seem unkind. It is however, unavoidable if we are to provide policy makers with vital information on the wide-ranging consequences that could be prevented through future investments in initiatives to reduce stillbirth.

 

Reproduced from: Campbell HE, Kurinczuk JJ, Heazell AEP, Leal J, Rivero-Arias O. Healthcare and wider societal implications of stillbirth: a population-based cost-of-illness study. BJOG 2018;125:108–117, https://doi.org/10.1111/1471-0528.14972