STAR clinic

Introduction

Stillbirth is a tragedy that strikes six Australian families every day. It is more common than Sudden Infant Death Syndrome and despite advances in many areas of obstetric care, the rate of stillbirth has remained static over the past decade. Recurrent miscarriage (three or more miscarriages in a row) is also a devastating experience for couples. “In the past, there has been little recognition of the special needs of women carrying a pregnancy after previous loss,” says Dr Elizabeth McCarthy. “We now know that outcomes are optimised when these families receive multidisciplinary support in a subsequent pregnancy.”

For some women there may be clear treatable or "one-off" medical factors that contributed to their previous stillbirth or miscarriage. For others, there may information to indicate that a specific fetal or placental abnormality was responsible. However, for many women, the exact causes of their stillbirth or miscarriages remain unclear. 

Our service

STAR (Stillbirth and Reproductive Loss) Clinic cares for women who have suffered a midtrimester or later pregnancy loss or repeated early pregnancy losses. We recognise that women who have experienced the loss of a baby due to stillbirth or multiple miscarriages require specialist pre-pregnancy advice, investigation, and extra support during their next pregnancy. Our clinic provides obstetric, midwifery, point-of-care ultrasound and perinatal health for these women and their families. Prior to January 2019, the clinic was known as Rainbow clinic.

The STAR clinic also offers ongoing obstetric care for women whose unborn baby has been diagnosed with a severe life-limiting condition (e.g. anencephaly, or a lethal chromosome condition).  Shared decision-making around birth and supportive paediatric care are discussed with the paediatric and obstetric teams, with pastoral care and social work support.

For clinicians - who should be referred?

Women with recurrent miscarriage (3 consecutive miscarriages < 10 weeks gestation), a single late miscarriage (fetus with crown rump length > 30mm, or > 10 weeks gestation at the time of demise) or previous stillbirth. This clinic also accepts referrals of families where the fetus is known to have a life-limiting condition, and expectant care during pregnancy and palliative care of the newborn is being considered.