Relative Risk Prolonged Pregnancy A3 Teaching Tools

Download and printout an A3 teaching tool illustrating the relative increase in risk (though I prefer to say chance) of stillbirth for 'low risk' pregnancies at different weeks of gestation, based on the study cited by Sara Wickham in her book 'In your own time' about making informed decisions regarding induction (Muglu et al 2019). Download with a license for birth workers, doulas, hypnobirthing teachers, prenatal yoga teachers, antenatal educators and midwives to print to share and use with pregnant women, birth partners and clients.

Please know that I've created these with the best intentions and don't mean to offend or hurt anyone who has experienced a stillbirth, and feel sure that a doula or teacher would use them sensitively and appropriately for their individual clients. I feel we mustn't let the fear of triggering others trauma stopping us from talking about the 'good news' of pregnancy and birth, and helping inform people about the relative risk of going 'over' their estimated due date is incredibly important when our induction rates are so high.

A consultant may say that the risk of stillbirth 'doubles', but when you look at it in relative terms the chance of stillbirth remains incredibly small, and if there aren't any specific indications that the baby or mother is at risk we are better to allow our bodies to finish the job on their own. Inductions, and the medical interventions that are more likely to come after them, come with their own risks.

I hope this visual might help to reassure or prepare birthing clients for discussions about induction based purely on a 'prolonged' (I don't like that term as it implies our bodies are just dragging it out!) pregnancy.

"A further study by Muglu et al (2019) has attempted to determine the chance of stillbirth at each gestational week from 37-weeks gestation. They reported the chance of stillbirth to be 0.11 per 1 000 at 37-weeks gestation, increasing to 3.18 per 1 000 at 42-weeks gestation (Muglu et al, 2019). While this is a statistically significant increase, it is still a small chance of an adverse outcome and therefore parents must be informed of both the absolute and relative risks of continuing a pregnancy beyond 41-weeks gestation.

One factor that must be taken into consideration for all these papers is that while there may be a small increase in absolute risk of stillbirth for those who opt for later induction of labour, every person is an individual and therefore their risk will be individualised.

While there is clearly an argument for induction of labour, it should not become a commonplace routine paradigm, but an intervention offered based on individualised risk factors and open discussions with the mother. This should include providing the actual and relative risks of each option so parents can make a fully-informed decision about the path they wish to take." British Journal of Midwifery

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Copyright and Limited Use Commercial License

The limited use commercial license that comes with this download means that birth workers, doulas, hypnobirthing teachers, prenatal yoga teachers, antenatal educators and midwives can print to share and use with pregnant women, birth partners and clients. By buying this download you are agreeing to the following terms:

The license means you - as an individual - can:

• Print the downloads on paper or card at the size specified
• Give the printouts as handouts to your clients, or use as teaching tools or posters for your business
• You may use use a professional print service or print at home
• Add the images to a Powerpoint presentation to use with clients in person or remotely, as long as the presentation file itself isn't shared digitally
• Share the content using photos or videos of your printed materials on social media

The license DOES NOT allow you to:

• Print the images for any other reason than above or on any other material e.g. on a notebook or mug to give away
• Use the images as part of a product you will sell
• Share the digital files with anyone by email or another method
• Add the digital files to your website or use on social media
• Edit the images or remove my brand name
• Share with other professionals in your organisation

Thank you for respecting the time that has gone into creating this artwork. If you have any questions about the license agreement, please contact me.

Copyright

These handmade images, text and files are copyright of Hannah Thomas of Womb to World Art and sole copyright is retained by them.

Disclaimer: Please note my images are stylised visual representations, and the information is accurate to the best of my knowledge, but I am not a medical professional and therefore there may be words or parts of the drawings that aren't 100% anatomically and medically accurate. My materials are not intended to replace any medical caregiver advice.