DISEASES AND CONDITIONS

Stillbirth

August 18, 2018

Stillbirth

Stillbirth is when a baby dies in the womb after 20 weeks or more of growing.

What causes stillbirth?

Stillbirth can be caused by many things, such as:

  • Diabetes or high blood pressure in the mother

  • An infection in the mother or in the baby

  • Birth defects because of genetic problems or other causes

  • Fetal growth restriction

  • Mismatched blood proteins between mother and baby (Rh disease)

  • A problem with the umbilical cord. This includes knots, a too-tight cord, a cord wrapped around the baby’s body or neck, or the cord dropping through the open cervix after the membranes have ruptured (cord prolapse).

  • A problem with the placenta, such as poor blood supply, or a shared placenta between twins (twin-to-twin transfusion)

Symptoms of stillbirth

Some symptoms of stillbirth can include:

  • Stopping of the baby’s movement and kicks

  • Light to heavy bleeding

  • No baby heartbeat heard with a stethoscope or Doppler

Diagnosing stillbirth

Stillbirth is diagnosed with an ultrasound test. The test shows lack of movement and heartbeat of the baby. The ultrasound test may also help the healthcare provider understand why the baby died. Blood tests may also be done to see what caused the stillbirth. The placenta and baby may be examined after delivery to learn more about the cause.

Treatment for stillbirth

Treatment of a woman after stillbirth varies. It depends on factors such as how long the baby has been in the womb, the size of the baby, and how much time has passed since the baby’s heartbeat stopped. Treatment may be done by one of these methods:

  • Waiting for labor to happen on its own

  • Dilating the cervix and using tools to deliver the baby

  • Inducing labor using medicine to open the cervix and cause the uterus to contract and deliver the baby

Coping with stillbirth

Stillbirth is very difficult for the parents, and often other family members. It can be more upsetting than an early miscarriage because the mother has felt the baby move. It can be very hard to go through labor, yet not have a baby to take home. Counseling is important for all parents coping with a stillbirth. It can help you understand your feelings and begin the work of grieving. Talk with your healthcare provider to be referred to a counselor with experience in pregnancy loss.

Grieving the loss of your child

Give yourself time to grieve the loss of your baby. There are ways to help you move through the grieving process. You may wish to hold and touch the baby. In a private room, a nurse or counselor will bring the baby to you, wrapped in a blanket. This can give you a real memory of your baby. Seeing your baby can be helpful when there is a birth defect. Sometimes, a parent may imagine a birth defect as much worse than the real problem. You may also wish to take photographs or footprints of your baby, or take a lock of hair to keep. You may wish to remember the baby with a memorial or funeral service. This can also help friends and other family members understand the loss that you have experienced.

Learning more about the cause of death

Some parents may wish to learn more about the cause of their baby's death. An autopsy or special genetic and chromosomal testing may be options. Talk with your healthcare provider. Results can be shared at a meeting with your healthcare provider several weeks afterward. Autopsy does not prevent you from being able to see or hold the baby, and can be done before a funeral.

 

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

  • Fever of 100.4°F (38°C) or higher

  • Pain or bleeding

  • Symptoms of depression

  • Other symptoms as advised

Updated:  

August 18, 2018

Sources:  

Caring for families experiencing stillbirth: Evidence-based guidance for maternity care providers. Peters M. Women and Birth. 2015; 28:272-78., Evaluation of stillbirth. UpToDate, Fetal demise and stillbirth: Incidence, etiology, and prevention. UpToDate, Fetal demise and stillbirth: Maternal care. UpToDate, Meeting the needs of parents after a stillbirth or neonatal death. Flenandy V. BJOG. 2015; 122(6):891., Perinatal mortality. UpToDate

Reviewed By:  

Burd, Irina, MD, PhD,Freeborn, Donna, PhD, CNM, FNP