Recommendation 1

3.75    The committee recommends that the Australian government reviews and amends the Fair Work Act 2009 (Cth) and provisions relating to stillbirth in the National Employment Standards (NES) to ensure that:

• provisions for stillbirth and miscarriage are clear and consistent across all employers, and meet international best practice such as those contained in the Ausgrid Enterprise Agreement; and
• legislative entitlements to paid parental leave are unambiguous in recognising and providing support for employees who have experienced stillbirth.

Recommendation 2

4.126    The committee recommends that the Australian Health Ministers' Advisory Council agrees to prioritise the development of a comprehensive, standardised, national perinatal mortality data collection that:

• includes information on timing and cause of death, autopsy and termination of pregnancy; and
• links to the National Death Index and perinatal mortality data collections to utilise information on maternal health, pregnancy and birth risk factors.

Recommendation 3

4.131    The committee recommends that the Australian government seeks advice from the Medical Services Advisory Committee on the economic costs and benefits of adding stillbirth autopsies as a new item in the Medicare Benefits Schedule, and urges the government to consider funding the projected cost of this new item in the 2019−20 Federal Budget.

Recommendation 4

4.133    The committee recommends that the Australian government consults with the Royal College of Pathologists of Australasia and relevant education and training authorities to identify strategies for increasing the number of perinatal pathologists available to undertake stillbirth investigations in Australia, including identifying costs and sources of funding.

Recommendation 5

5.81    The committee recommends that, through the Australian Health Ministers' Advisory Council, the Australian government leads a process to establish a set of national stillbirth research funding priorities for the next 10 years, drawing on those developed by the Perinatal Society of Australia and New Zealand and Centre of Research Excellence in Stillbirth. This set of priorities should:

• draw on the experiences and knowledge of parents, parent-based support and advocacy organisations, international expert researchers, clinicians and other health professionals; and
• enable government, philanthropic and corporate funding bodies to identify, prioritise and coordinate efforts to produce the best and most cost-effective outcomes through collaborative research programs, including 'discovery projects' which explore new technologies that may prevent stillbirth.

Recommendation 6

5.83    The committee recommends that the Australian government reviews current research funding arrangements administered by the National Health and Medical Research Council, in consultation with a roundtable of relevant stakeholders, to examine options for longer-term funding cycles for targeted, large-scale, collaborative research partnerships, potentially through the Medical Research Future Fund.

Recommendation 7

5.86    The committee recommends that the Australian government gives urgent consideration to the allocation, through the Medical Research Future Fund, of long-term dedicated funding and support for the development of a national biobank for stillbirth placenta research.

Recommendation 8

6.85    The committee recommends that, through the Australian Health Ministers' Advisory Council, the Australian government leads a process to develop a national culturally and linguistically appropriate continuity of care model aimed at reducing the rate of stillbirths in Australia, particularly amongst groups identified as having a higher risk of stillbirth.

Recommendation 9

6.91    The committee recommends that the Department of Health, in consultation with local communities, develops national best practice guidelines for hospitals and health centres on providing culturally appropriate support and information for bereaved families who have experienced stillbirth, drawing on successful models such as the Integrated Support After Infant Loss clinic. The guidelines should include provision for bereavement support and address the specific needs of:

• bereaved fathers, siblings, grandparents and other family members;
• families from rural and remote communities;
• Aboriginal and Torres Strait Islander families; and
• families from culturally and linguistically diverse backgrounds.

Recommendation 10

7.97    The committee recommends that the Australian government develops and implements a national stillbirth public awareness campaign, similar to the successful SIDS campaign, which aims to demystify stillbirth, educates parents and the general public about the risks of stillbirth, and encourages public conversations about stillbirth as a public health issue.

Recommendation 11

7.100    The committee recommends that the Australian government develops and implements a national best-practice, culturally appropriate education kit that equips current and future health professionals to:

• discuss risks of and strategies for preventing stillbirth with pregnant women; and
• provide culturally and linguistically appropriate information about counselling and support services to assist them with emotional support whilst caring for parents following a stillbirth.

Recommendation 12

7.104    The committee recommends that the Australian government develops and implements culturally and linguistically appropriate protocols for public hospitals and community health services in all jurisdictions, to guide them in:

• managing autopsies or other investigations into stillbirths;
• counselling for autopsy and other medical investigations;
• care of stillborn babies held in morgues; and
• communicating with bereaved parents.

Recommendation 13

7.107    The committee recommends that the Australian government creates an online register of current international and Australian research and clinical guidelines relating to stillbirth, accessible to all interested stakeholders including the public.

Recommendation 14

7.110    The committee recommends that the Australian government develops and implements a best-practice, culturally appropriate public education kit that assists families, friends, employers, work colleagues and people in the wider community to understand stillbirth and to offer support to a bereaved parent or family member following a stillbirth.

Recommendation 15

8.44    The committee recommends that, through the Australian Health Ministers' Advisory Council, the Australian government leads a process to develop and implement a National Stillbirth Action Plan aimed at reducing the rate of stillbirth in Australia by 20 per cent over the next three years (Budget forward estimates), and including:

• a nationally-coordinated and consistent framework for stillbirth reporting and data collection;
• an online register of stillbirth research and data;
• national research priorities; and
• a public education campaign.

Recommendation 16

8.48    The committee recommends that annual progress reports on the development and implementation of the National Stillbirth Action Plan to reduce the rate of stillbirth in Australia are provided to the Council of Australian Governments Health Council and made publicly available.

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