What causes stillbirth? What happens if a baby is stillborn? Find out about potential causes and prevention.
A stillborn baby is a baby born after the 24th week of pregnancy who does not show any signs of life. If the baby dies in the womb, it is known as an intra-uterine or antepartum stillbirth. If the baby dies during labour, it is called an intra-partum stillbirth.
If a baby has died in the womb before labour starts, labour is usually induced. Occasionally there may be a reason why vaginal delivery is not recommended and then a caesarean section will be carried out. Generally, going through labour is the safter option for the mother than having a caesarean section.
The number of stillbirths around the UK varies slightly between the regions. In Wales it is 5.2 per 1000 births, in England 5.1, in Scotland 4.9 and in Northern Ireland 4.1.
The parents would be supported by a midwife who can help them as they spend some quiet time with their baby. They may want to hold their baby, take photographs and create as many memories as they can. The idea of this may sound frightening but many parents say the time spent with their baby is very precious.
The midwife can help the parents organise any religious observances and begin to arrange a funeral.
Conditions that we do know can lead to stillbirth include:
- The baby has a genetic or inborn physical defect
- The placenta separates from the womb too early
- Severe pre-eclampsia, eclampsia or pregnancy-induced hypertension
- A late pregnancy or birth complication that reduces the supply of oxygen to the baby
- An infection during pregnancy, such as listeriosis or some viral infections
- Antepartum haemorrahage
- Obstetric cholestasis - a liver disorder in the mother.
There are also a number of factors among parents that are associated with a higher risk of stillbirth. These include:
- having twins or a multiple pregnancy
- having diabetes, high blood pressure or a blood-clotting disorder
- being a smoker or being exposed to tobacco smoke
- being obese.
It is also true that older mothers (over 35) and younger mothers (under 20) have a higher chance of experiencing stillbirth. However, many stillbirths are unexplained.
We don't know the reasons for many stillbirths. But if you are expecting a baby, it is a good idea to follow the advice from your midwife or GP, which will help to reduce the risk and keep your baby healthy. Actions include:
- Stopping smoking.
- Telling your midwife about any abdominal pain or vaginal bleeding.
- Going to sleep on your side in the third trimester.
- Protecting yourself against infection.
- Asking your midwife for information about avoiding certain foods.
- Attending all your antenatal appointments.
- Be aware of your baby's movements towards the end of pregnancy, if your midwife advises it.
Babies are just as active at the end of the pregnancy - the movements will probably feel different because the baby has less room to move around, but they should be as strong and frequent as they were before. A change in how you feel, or your baby’s movements or growth pattern may be a warning sign that tests are needed. Contact your midwife or the hospital delivery suite straight away if you are worried.
New research from the charity, Tommy's, has found that going to sleep on your side in the third trimester can reduce the risk of stillbirth. This recommendation includes:
- going to sleep at night,
- returning to sleep after waking up in the night and
- day-time naps.
As the going-to-sleep position is the one held longest during the night, don't worry if you wake up on your back, just roll back onto their side. Watch this video to find out more.
Making sure you attend all your antenatal appointments will help your midwife or GP to keep track of the size of your baby. You can also discuss the pattern of your baby’s movements so you can be aware of any changes that need investigating. You will also be offered a series of checks to detect and treat any illnesses or conditions, such as pre-eclampsia, that may cause complications for you or your baby.
Many hospitals and most GPs can refer parents for counselling following stillbirth.
The national charity Sands (Stillbirth & Neonatal Death Charity) runs a helpline, provides information and funds research into the causes of stillbirth. Call the helpline on 020 7436 5881 9.30am to 5.30pm Monday to Friday or email the confidential email helpline: email@example.com.
NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700.
NCT’s Shared Experiences helpline can also be a useful source of support. The helpline can put anyone who has had a challenging experience of pregnancy, birth or early parenthood, in touch with someone who has had had a similar experience to listen to their concerns and share their stories. Call on 0300 330 0774, 9am – 3pm Tuesday, Wednesday and Thursday, or leave a message outside these hours.
Tommy's, a charity which funds research into stillbirth, premature birth and miscarriage publishes it's booklet "Pre-eclampsia: Your questions answered".