A stillbirth is when a baby dies in the womb during the last 20 weeks of pregnancy. A miscarriage is a fetal loss in the first half of pregnancy.
More about Stillbirth
About 1in 160 pregnancies end in stillbirth. Stillbirth is less common than in the past because of better pregnancy care. Up to half of the time, the reason for the stillbirth is never known.
Some factors that can cause stillbirth are:
Infection in the mother or fetus
Chronic health conditions in the mother (such as diabetes, epilepsy, or high blood pressure)
Problems with the placenta that prevent the fetus from getting nourishment (such as placental detachment)
Sudden severe blood loss (hemorrhage) in the mother or fetus
Heart stoppage (cardiac arrest) in the mother or fetus
Umbilical cord problems
Women at higher risk for stillbirth:
Are older than age 35
Are carrying multiple babies (twins or more)
Have had a previous stillbirth
Have high blood pressure or diabetes
Have other medical conditions (like lupus)
What Will Happen?
The doctor will use ultrasound to confirm that the baby’s heart has stopped beating. If the woman’s health is at risk, she will need to deliver the baby right away. Otherwise, she can choose to have medicine to start labor or wait for labor to begin on its own.
After the delivery, doctors will look at the placenta, fetus, and umbilical cord for signs of problems. The parents will be asked for permission to do more detailed tests. These may include internal exams (autopsy), x-rays, and genetic tests.
It is natural for parents to feel uneasy about these tests when they are dealing with the loss of a baby. But learning the cause of the stillbirth can help a woman have a healthy baby in the future. It may also help some parents cope with their loss to know as much as they can.
Coping with the Grief
Stillbirth is a tragic event for a family. The grief of a pregnancy loss can raise the risk of postpartum depression. People cope with grief in different ways. It may be helpful to talk to your doctor or a counselor about your feelings. Other things that can help you through the mourning are:
Pay attention to your health. Eat and sleep well so your body stays strong.
Find ways to express your feelings. Joining a support group, talking to family and friends, and keeping a journal are some ways to let out grief.
Educate yourself. Learn about the problem, what you might be able to do, and how other people have coped can help you.
Give yourself time to heal. Grieving is a process. Accept that it will take time to feel better.
The Risk for Stillbirth
Women who have had a stillbirth have a high chance of a healthy pregnancy in the future. Placenta and cord problems or chromosome defects are unlikely to occur again. Most women have 97% chance of having a healthy pregnancy following a stillbirth.
Some things you can do to help prevent another stillbirth are:
Meet with a genetics counselor. If the fetus died because of an inherited problem, you can find what your risks are in the future.
Talk to your doctor before you get pregnant. Make sure chronic health problems like diabetes are in good control. Tell your doctor about all your medicines, even the ones you buy at the drugstore.
Lose weight if you’re overweight. Obesity raises the risk of stillbirth. Talk to your doctor about how to safely lose weight before you get pregnant.
Adopt good health habits. Smoking, drinking, and using street drugs are dangerous during pregnancy. Get help quitting before you get pregnant.
Get special prenatal care. Women who have had a stillbirth will be watched carefully during pregnancy. They may need special tests to monitor their baby’s growth and well-being.
When to Call the Doctor
Call the doctor if you have any of the following problems:
You have a fever.
You have heavy vaginal bleeding.
You feel sick, are throwing up, have diarrhea, or have abdominal pain.
You are depressed and feel like you cannot cope with what has happened.
You have not felt the baby move as much as normal. Normally you should expect the baby to move 10 times in the hour after you eat while you are sitting still and counting.
Simpson JL, Jauniaux ER. Pregnancy loss. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 26.
Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.