Research Article|Articles in Press

Evaluating the reach and impact of Still Six Lives: A national stillbirth public awareness campaign in Australia

Published:February 27, 2023DOI:



      The Still Six Lives campaign aimed to increase awareness of stillbirth among Australian women and educate people about three modifiable behaviours that pregnant women could take to reduce the risk of stillbirth. The campaign used earned media, digital advertising and social media.


      The aim of this study is to evaluate the impact of the campaign on Australian women’s awareness of stillbirth, and knowledge of the three modifiable behaviours.


      The study collected process evaluation data about campaign implementation from digital platforms. The impact evaluation comprised of two components: a three-wave community survey of Australian women aged 18–50 years old, and a pre-post cross-sectional maternity service survey of pregnant women.


      The campaign gained significant reach, including 2,974,375 completed video views and 910,000 impressions via social media influencers. The community surveys had 1502 participants at baseline, 1517 mid-campaign and 1598 post-campaign. Participants were slightly more likely to have encountered messages about stillbirth after the campaign (aOR 1.30, 95% CI 1.09–1.55). There were increases in awareness of each behaviour after the campaign: be aware of baby’s movements (aOR 1.26, 95% CI 1.08–1.47), quit smoking (aOR 1.27, 95% CI 1.10–1.47) and going-to-sleep on side (aOR 1.55, 95% CI 1.32–1.82). The antenatal clinic survey had 296 participants at baseline and 178 post-campaign. Post-campaign, there was an increased likelihood that women were aware of side-sleeping (aOR 3.11, 95% CI 1.74–5.56).


      The national campaign demonstrated some evidence of change in awareness of three modifiable behaviours that can reduce the risk of stillbirth.


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        • Pollock D.
        • Pearson E.
        • Cooper M.
        • Ziaian T.
        • Foord C.
        • Warland J.
        Voices of the unheard: a qualitative survey exploring bereaved parents experiences of stillbirth stigma.
        Women Birth. 2020; 33: 165-174
        • Pollock D.
        • Shepherd C.C.J.
        • Adane A.A.
        • Foord C.
        • Farrant B.M.
        • Warland J.
        Knowing your audience: investigating stillbirth knowledge and perceptions in the general population to inform future public health campaigns.
        Women Birth. 2022; 35: e389-e396
      1. Australian Institute of Health and Welfare. Stillbirths and neonatal deaths. 18 Nov 2021 2021. 〈〉 (accessed 22 April 2022).

        • Heazell A.E.P.
        • Siassakos D.
        • Blencowe H.
        • et al.
        Stillbirths: economic and psychosocial consequences.
        Lancet. 2016; 387: 604-616
        • Flenady V.J.
        • Middleton P.
        • Wallace E.M.
        • et al.
        Stillbirth in Australia 1: the road to now: two decades of stillbirth research and advocacy in Australia.
        Women Birth. 2020; 33: 506-513
        • Page J.M.
        • Thorsten V.
        • Reddy U.M.
        • et al.
        Potentially preventable stillbirth in a diverse U.S. Cohort.
        Obstet. Gynecol. 2018; 131: 336-343
        • Nuzum D.
        • Meaney S.
        • O'Donoghue K.
        The public awareness of stillbirth: an Irish population study.
        BJOG Int. J. Obstet. Gynaecol. 2018; 125: 246-252
        • Gordon A.
        • Chan L.
        • Andrews C.
        • et al.
        Stillbirth in Australia 4: breaking the silence: amplifying public awareness of stillbirth in Australia.
        Women Birth. 2020; 33: 526-530
      2. Commonwealth of Australia. Select Committee on Stillbirth Research and Education Report. Canberra, 2018.

        • Andrews C.J.
        • Ellwood D.A.
        • Gordon A.
        • et al.
        Stillbirth in Australia 2: working together to reduce stillbirth in Australia: the Safer Baby Bundle initiative.
        Women Birth. 2020; 33: 514-519
      3. Icon Agency. Still Six Lives: reducing the risk of stillbirth across Australia. n.d. 2022. 〈〉 (accessed 6/09/2022.

        • Saastad E.
        • Tveit J.V.
        • Flenady V.
        • et al.
        Implementation of uniform information on fetal movement in a Norwegian population reduced delayed reporting of decreased fetal movement and stillbirths in primiparous women - a clinical quality improvement.
        BMC Res. Notes. 2010; 3: 2
        • Wackers K.J.W.M.
        • Wassen M.M.L.H.
        • Zeegers B.
        • Bude L.
        • Nieuwenhuijze M.J.
        Effect of the use of a national information brochure about fetal movements on patient delay.
        Women Birth. 2019; 32: 131-136
        • Flenady V.
        • Gardener G.
        • Ellwood D.
        • et al.
        My Baby’s Movements: a stepped‐wedge cluster‐randomised controlled trial of a fetal movement awareness intervention to reduce stillbirths.
        BJOG Int. J. Obstet. Gynaecol. 2022; 129: 29-41
        • Norman J.E.
        • Heazell A.E.P.
        • Rodriguez A.
        • et al.
        Awareness of fetal movements and care package to reduce fetal mortality (AFFIRM): a stepped wedge, cluster-randomised trial.
        Lancet. 2018; 392: 1629-1638
        • Chan L.
        • Gordon A.
        • Warrilow K.
        • et al.
        Evaluation of Movements Matter: a social media and hospital‐based campaign aimed at raising awareness of decreased fetal movements.
        Aust. N. Z. J. Obstet. Gynaecol. 2021;
        • Warrilow K.A.
        • Gordon A.
        • Andrews C.J.
        • et al.
        Australian women’s perceptions and practice of sleep position in late pregnancy: an online survey.
        Women Birth. 2022; 35: e111-e117
        • Cronin R.S.
        • Li M.
        • Thompson J.M.D.
        • et al.
        An individual participant data meta-analysis of maternal going-to-sleep position, interactions with fetal vulnerability, and the risk of late stillbirth.
        EClinicalMedicine. 2019; 10: 49-57
        • Pollock D.
        • Ziaian T.
        • Pearson E.
        • Cooper M.
        • Warland J.
        Breaking through the silence in antenatal care: fetal movement and stillbirth education.
        Women Birth. 2020; 33: 77-85
      4. Australian Institute of Health and Welfare. Australia’s mothers and babies 2018—in brief. Canberra: AIHW, 2020.
        • Li R.
        • Lodge J.
        • Flatley C.
        • Kumar S.
        The burden of adverse obstetric and perinatal outcomes from maternal smoking in an Australian cohort.
        Aust. N. Z. J. Obstet. Gynaecol. 2019; 59: 356-361
      5. Australian Institute of Health and Welfare. National Core Maternity Indicators. Canberra: AIHW, 2021.