Dr HAINES (Indi) (13:13): I rise to speak in favour of the Fair Work Amendment (Improving Unpaid Parental Leave for Parents of Stillborn Babies and Other Measures) Bill 2020, which makes sensible, compassionate changes to the Fair Work Act to protect the rights of parents experiencing the most unimaginable of tragedies: the death of an infant.
Six babies are stillborn in Australia every day—2,000 a year. It’s the most common cause of child mortality. For most cases, we don’t know the cause. Under current legislation, parents on unpaid parental leave who experience a stillbirth or the death of their child in the first 24 months of life can be recalled to work by their employer with just six weeks notice. Parents on adoption related unpaid parental leave whose child dies in the first 24 months of life can be recalled to work by their employer with just four weeks notice.
For parents experiencing this most profound grief, these rules are cruel.
They are unworthy of the decent country that we are, and it is so right that they be changed. This Bill will give parents of stillborn babies access to the same unpaid parental leave entitlements as other families—a guaranteed 12 months of unpaid parental leave. For an employee whose child dies during the first 24 months of life, the Bill will ensure that their employer will no longer be able to cancel any upcoming unpaid parental leave they might have, or, if they’re already on leave, require them to return to work earlier than they may wish to.
The legislation will also give more flexibility to parents of premature babies or babies that require immediate hospitalisation after birth by allowing those parents to go back to work while their child is in hospital, if they choose to, and then recommence unpaid parental leave when their child comes home. These are structural changes which will never dampen the pain, but they will recognise it.
Thursday 15 October was Pregnancy and Infant Loss Remembrance Day. Leading into that day was a story of such loss by Sophie Aubrey in The Sydney Morning Herald. It was the story of Victoria and Danny Liston and their baby daughter, Kiera, who died soon after her birth. Baby Kiera was born at full term after an uneventful pregnancy and birth, but her condition deteriorated rapidly and she was whisked from her mother’s arms into the neonatal intensive care unit, where the staff tried to save her. Victoria and Danny said of Kiera’s life:
It’s not just those five hours after she was born, and not just those few days in hospital after—when they could keep her and hold her—it was actually from the moment we found out we were pregnant.
Victoria says they have devoted their lives now to keeping their little girl present, saying, ‘She will be part of our family forever and, when we have future children, they will know about her.’
This story was a powerful trigger to me of the many experiences I’ve had as a midwife, caring for parents who’ve suffered miscarriage, stillbirth and infant death. The scene of the intensive care unit—noisy, intense, pressured. The shock. The desperate faces of parents. The longing for a miracle from the skilled hands of the paediatricians, midwives and nurses.
But also there were other times, when a couple were admitted, knowing their little baby had died in utero. The sombre and quiet preparation for the birth. The grief, the fear, and the gossamer thread of hope that all of this was just some terrible mistake and their little baby would be born alive. Then came the birth itself. It was always the sound of silence at the birth that struck me. No cry, no sounds of life. The quiet movements of the midwife as the little baby is lifted to his mother and respectfully wrapped. The respectful confirmation that a longed-for heartbeat was indeed silent. The stillness. A sacred moment of a different type. It wasn’t always so.
The opportunity for parents to hold and keep their stillborn baby close with them after the birth is relatively recent. Common wisdom was to spare the mother the pain of seeing the child in order to help her get over it. I have cared for elderly women in the last days of their lives who recounted the grief and the still unbearable loss of a baby who had died many decades earlier who they never held and often never named.
This brings me to research. On 27 March 2018, the Senate established the Select Committee on Stillbirth Research and Education to inquire into, and report on, the future of stillbirth research and education in Australia. That committee tabled its report on 4 December 2018. I refer the House to an important submission to that committee from a colleague of mine, Professor Caroline Homer AO, Distinguished Professor of Midwifery at the Centre for Midwifery, Child and Family Health at the University of Technology Sydney, and now Director of Maternal, Child and Adolescent Health at the Burnet Institute. She highlighted strong research from around the world, half of which is collected in Australia, that midwifery continuity of care is a model that can make a real difference in the prevention of stillbirth. The evidence base, she said, is clear: if women see the same few midwives throughout their pregnancy, they will know those midwives and those midwives will know those women during labour and birth.
We find from that evidence that there are fewer preterm births and these women are less likely to lose their babies and will have a much more positive experience. But this is not happening across the country. There are pockets of exemplary practice, and indeed there is policy that the state level, but we have no national-level policy for continuity of midwifery care.
The submission from the Australian College of Midwives made a similar call, stating the need for a universal approach to stillbirth research and education across Australia that includes:
- Greater consistency and transparency of data collection between states and jurisdictions so that research and education can be informed by accurate and up to date national data
- Resourcing of continuity of midwifery care implementation research, so that every woman in Australia has access to a known midwife
- Working to provide culturally appropriate care to Aboriginal and Torres Strait Islander women, as well as refugees and migrants which comprises access for all Aboriginal and Torres Strait Islander women to midwives and healthcare workers
I’m pleased that the Australian government responded to that Senate report with an investment of $7.2 million in initiatives designed to reduce stillbirths. The Centre of Research Excellence in Stillbirth is one such funded initiative. It has grown from the work of the Perinatal Society of Australia and New Zealand, who it maintains a very strong linkage with.
The Stillbirth CRE recognises that stillbirth has enormous economic and psychosocial impacts for women, parents, families, communities and the health system; that there has been little reduction in stillbirth rates for over 20 years; that women from disadvantaged backgrounds have a greater risk of stillbirth than the average population; and that families whose child is stillborn often receive sub-optimal care. The stillbirth rate in Australia is approximately 35 per cent higher than those of the top-performing countries globally. In up to 50 per cent of stillbirths, deficiencies in care are identified, and in around 20 to 30 per cent the death is avoidable due to these factors. That’s shocking.
In partnership with health departments across Australia, a ‘bundle of care’ to address the priority evidence practice gaps in stillbirth prevention has been developed and implemented. Similar care bundles in England and Scotland have shown a 20 per cent reduction in stillbirth rates. So the goal here in Australia is to implement these bundles after 28 weeks gestation and reduce our rate by 20 per cent. The Stillbirth CRE has led the development of these bundles of care to address the priority evidence gap, and the Safer Baby Bundle consists of five elements designed to reduce stillbirth rates after 28 weeks gestation: firstly, by improving the awareness and care of women with decreased fetal movements; secondly, by doing pregnancy risk assessment and ongoing monitoring for fetal growth restriction; thirdly, by supporting women to stop smoking; fourthly, by providing advice for pregnant women on maternal sleeping positions; and, fifthly, by supporting shared decision-making around timing of birth for women with high risk factors for stillbirth.
There are some moments in this place where we actually get to do something good, and this legislation is one of them. It comes from such good work that came out of our Senate committee. I join with others in this House to congratulate our members in the Senate who brought this important work to our attention and enabled legislation such as this to be made.
In conclusion, given the year that we have had, the isolation of the pandemic has exacerbated the grief and loneliness felt by parents who have experienced a stillbirth or infant loss this year. I encourage people to reach out to bereaved loved ones and friends, not just at the time of that birth but long into the future, because that grief never goes away. The lifetime of loss is one of love and longing. I commend this bill to the House.