Stillbirth: what it means and what causes it

What is stillbirth?

A stillbirth is the death of a baby after 24 weeks of pregnancy, before or during birth. If a baby dies before 24 weeks have been completed, it’s called a miscarriage (NHS, 2021a).

Many mothers who have a late miscarriage also give birth to their baby and, understandably, feel that this should be called a stillbirth. If you, your partner or friend has experienced a miscarriage or stillbirth, there is support available (see Further information at the end of this article).

How common is stillbirth?

In the UK around one in 200 pregnancies end in stillbirth (Smith, 2015; NHS, 2021a).

What causes stillbirth?

Some stillbirths may be linked to complications with the placenta, a birth defect or the mother's health. For others, no cause is found.

It can often be hard to find out the cause of death when a baby is stillborn (NHS, 2021a,b). More research is needed around investigating and identifying the causes of stillbirth (Smith, 2015; Wojcieszek et al, 2018).

What increases the risk of stillbirth?

A number of factors are associated with the risk of stillbirth. But many of these are outside the pregnant woman’s control. They include: 

• Age
• Ethnicity
• Poor diet
• Smoking or an unhealthy relationship with drugs and alcohol
• Pre-existing health conditions or new infections
• Low socio-economic status
• Maternity history.

What can I do to reduce the chance of stilbirth?

Attend all antenatal appointments

Regularly meeting with your midwife enables them to monitor the growth and wellbeing of your baby throughout pregnancy. That means they can spot any changes and investigate them further if needed (Smith, 2015).

Make sure you tell your midwife about any medical conditions you have so they can be managed. For example, women who might be at risk of pre-eclampsia can reduce the likelihood of stillbirth by taking low-dose aspirin.

Protect against infection

Keeping up to date with flu, Covid and any other vaccinations will reduce the chance of infections during pregnancy and around the time of birth (Kady and Gardosi, 2004; Ota et al, 2020; DeSisto et al, 2021; NHS, 2021a). To avoid catching other infections, make sure you wash your hands, ask people to wear a mask to protect you and ensure your food is well cooked (NHS, 2021c).

Keep track of your baby’s movements

Most women first become aware of their baby’s movements from 16 to 24 weeks of pregnancy (NHS, 2021c). The number of your baby’s movements will tend to increase up until 32 weeks of pregnancy. After this, it stays about the same, although the type of movement might change towards the due date (RCOG, 2019).

Stating a ‘normal’ specific number of daily movements for unborn babies is not possible. What is important is recognising your baby’s individual pattern of movements and reporting any changes to your midwife or GP immediately (RCOG, 2019). Changes might be a sign that your baby is unwell and the sooner this is found out the better (NHS, 2021c).

If you think your baby’s movements have slowed down or stopped, contact your midwife or maternity unit immediately (NHS, 2021c).

Sleep position

Studies suggest an association between pregnant women’s sleeping position beyond 28 weeks and subsequent stillbirth (NHS, 2021b).

Mothers who have a stillborn baby were more likely to have gone to sleep lying on their backs the night before their baby’s death (Heazell et al, 2018). This could be linked to the fact that sleeping on your back can result in compression of your inferior vena cava (a large vein), which reduces blood flow to the baby (Smith, 2015).

It’s recommended that during pregnancy, women fall asleep on their side and not on their back. Try not to worry about waking up on your back because you can then return to your side. For more information see: https://www.tommys.org/pregnancy-information/im-pregnant/sleep-side/sle…

Culturally competent care

We know that mothers from Black, Asian and minority ethnic backgrounds in the UK experience disproportionate levels of stillbirth (MBRRACE-UK, 2020). We also know that this cannot be explained by life conditions such as poverty or standard of health alone, although these can also contribute; this suggests a level of racial inequality in maternity care (MBRRACE-UK, 2020; ONS, 2021).

Being aware of this may lead you to consider your plans for care during pregnancy, birth and the postnatal period. Seeking out anti-racist health professionals, or a doula, who are familiar with the issues and can actively support you, will help you feel more in control.

Avoid or reduce other risks

• Smoking.
• Alcohol and recreational drugs during pregnancy can seriously affect your baby's development and increase the risk of miscarriage and stillbirth.
• Limiting the amount of caffeine you consume during pregnancy to 200mg a day – two cups of instant coffee.

(RCOG, 2014; Heazell et al, 2020; NHS, 2021a)

This page was last reviewed in February 2022.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

If your baby has died or someone close to you has had a stillbirth, there is support available.

The charity Sands (Stillbirth and Neonatal Death charity) offers a helpline for parents and families affected by stillbirth: 0808 164 3332. It also offers various other forms of support. Click here for more details.

The charity Tommy’s offers a helpline run by midwives who have experience in talking about pregnancy loss and have had bereavement training. Call 0800 0147 800. Monday to Friday, 9am – 5pm.

The NHS website has more information about stillbirth.

You can also read our article on coping with stillbirth.