A stillbirth is the death of a baby before the moment of birth. In most states in the US, babies who die before 20 weeks of gestation are classified as miscarriages and babies who die at 20 weeks gestation or later are classified as stillbirths.
Video credit: Hunter Medical Research Institute (HMRI) and the University of Newcastle
The most common known causes of stillbirth include:
These conditions or circumstances have been shown to increase the risk of stillbirth.
Sometimes there are warning signs such as a change in baby’s movements, sharp abdominal or back pain, poor growth in baby, change in maternal health, change in baby’s heart rate pattern, sudden vaginal bleeding, or genetic or anatomic abnormalities in the baby. Unfortunately, there are many times when there are no warning signs.
You know your baby best and you should never hesitate to contact him/her if you have any questions or are feeling uneasy. You are not bothering them! As one health professional said – “You are not being a bother. You are being a mother.” Click here to order a free copy of our Parenting in Pregnancy Brochure or download and print an electronic copy.
You should contact your doctor if you experience any of the following:
A stillbirth is usually diagnosed by ultrasound. This may be done as part of routine prenatal care or to evaluate a concern. Some stillbirths occur while the mother is in labor or delivering. In this case, the stillbirth may be diagnosed by the fetal heart rate monitor or the baby being born without a heart beat.
Vaginal deliveries are the preferred option for most stillbirths. C-sections may be indicated in cases of breech presentation, previous c-section delivery, maternal health concerns, multiple gestation, or other situations identified by the family and health professional. Induction of labor is often preferred, but is not always necessary.
Options after a miscarriage typically include waiting for natural labor/miscarriage, medication to stimulate labor/miscarriage, Dilation & Curettage (D&C) procedure, or Dilation & Evacuaton (D&E) procedure depending on the family’s preferences and gestational age of the baby.
After a stillbirth, the mother’s body will have a post-partum response similar to any live birth. Families should be prepared for bleeding, pain management, responding to breast milk production, and healing from any medical procedures.
Several tests may be recommended after a stillbirth if the death was not expected (for example because of a diagnosed anatomic condition). These tests can help identify what caused the death and provide information about the health implications for the mother or future pregnancies. Examples of these tests include blood tests on mom, blood tests on baby or cord blood, placenta and umbilical cord examination, genetic testing, ultrasound/MRI, or autopsy.
Learn more about post-stillbirth testing options.
The physical recovery after a stillbirth will look very similar to the recovery after healthy deliveries. Mothers are encouraged to drink fluids and get rest. Pain management options are available. It can be easy to ignore physical complications such as excessive bleeding, infection, fever, or severe or new pain. Call your health professional immediately with any concerns.
Mothers should be reminded that their milk production will begin a few days after delivery. This can be painful both emotionally and physically. Some families like to pump this milk and donate it to a local milk bank. If you would like to suppress your milk production, wear tight sports bras, minimize stimulation, and use ice packs on the breasts. Other natural remedies may also be helpful.
Learn more about how you can care for yourself.
Other members of the family should also be encouraged to heal physically. Ensure all those impacted are eating well, drinking fluids, resting, and responding to new or severe pain/symptoms.
There is not a ‘right’ way to grieve after this type of loss. Grief looks different for each person. It can be common to have feelings of sadness, anger, despair, hopelessness, loneliness, or denial. Physical symptoms like headaches, nausea/vomiting, lack of appetite, and inability to sleep are also common.
It is important for each person to have the ability to grieve in a way that works for him/her. Grief can also change throughout the day or with more time.
Some families have found the following activities helpful:
Some grief tips:
Yes. Future pregnancies will be at higher risk for poor outcomes, but many people have gone on to have healthy pregnancies and babies. The first step is to talk to your health professional about the health concerns or risks that may have contributed to or resulted from your stillbirth. This information may provide information important to any decisions about future pregnancies.
The American Congress of Obstetrics and Gynecology (ACOG) recommends additional testing and monitoring for pregnancies after a stillbirth. Talk to your provider about what your care protocol would look like in subsequent pregnancies.
Learn more about having a pregnancy after a stillbirth.
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