Stillbirth

Pregnancy is a time of joy for most parents, filled with hope, excitement, and expectations for the future. But pregnancy can also be a time of worry and fear, particularly when it comes to your baby’s health. Sometimes, a baby develops health problems in the womb and, as a result, cannot survive to term. Known as a stillbirth, these deaths can be traumatic and difficult for any parent to have to deal with.

What is Stillbirth?

Stillbirth occurs when a baby dies after 20 weeks of pregnancy. It is related to miscarriage, which is the death of a fetus before 20 weeks of pregnancy. Also known as fetal death, stillbirth can occur in the uterus (intrauterine death) or within the birth canal, during labour and delivery (intra-partum death). Stillbirth often occurs unexpectedly and can take place in both healthy pregnancies and in those pregnancies complicated by other health issues. More than 3,500 babies in the United Kingdom are stillborn every year.

How Common is Stillbirth?

Unfortunately, stillbirth is a fairly common occurrence in all countries in the world. In the UK, approximately five out of every 1,000 babies will be stillborn. However, the incidence of stillbirth has dropped significantly in the past thirty years. In fact, there has been a 20% reduction in stillbirths since 1970. Though any woman can experience a stillbirth, there are certain factors that increase your risk of fetal death. These risk factors include:

• having a multiple pregnancy
• having pre-existing health conditions (such as high blood pressure)
• smoking during pregnancy
• using street drugs during pregnancy
• being over the age of 35

What Causes Stillbirth?

If you experience a stillbirth, your health care providers will do all they can in order to determine the cause of your baby’s death. However, pinpointing a cause can be difficult, as stillbirth is often the result of a combination of factors. In up to 50% of stillbirth cases, a cause for death is never fully determined. Possible causes can include:

• Placental Problems: The placenta serves as the baby’s main source of nourishment within the womb. Sometimes, the placenta can peel away from the uterus before birth, depriving the baby of oxygen and nutrients vital to his survival. Known as placental abruption, this condition is believed to be responsible for up to 16% of stillbirths.
• Birth Defects: Sometimes a fetus is created with faulty chromosomes, leading to problems in a baby’s genetic code. This can cause a number of serious birth defects, which makes it impossible for a baby to survive to term. Approximately 5% to 10% of stillbirths are the result of such genetic birth defects. Birth defects can also be the result of environmental toxins, such as chemical exposure or cigarette smoking.
• Infection: Some women develop infections that are dangerous to a baby during pregnancy. Bacterial infections, such as toxoplasmosis, listeria, and rubella, can cause serious health problems in a baby. STDs, such as syphilis, can also be responsible for stillbirths.
• Maternal Illness: Certain maternal health conditions can be a cause of intrauterine and intra-partum death. Women with diabetes and preeclampsia are at increased risk for having a stillborn baby. Women with maternal liver disease (obstetric cholestasis) are also at risk for having a stillbirth. In fact, 5% of all stillbirths can be attributed to this disease.
• Birth Trauma: Babies sometimes suffer from trauma during delivery that leads to stillbirth. Babies can get their umbilical cords wrapped around their necks, causing asphyxiation. Some babies suffer from shoulder dystocia (dislocated shoulder) during delivery, which can sometimes result in stillbirth.

Diagnosing a Stillbirth

Stillbirth is usually diagnosed during ultrasound scans at prenatal appointments. An ultrasound can detect whether a baby is moving or breathing normally. Fetal heart rate monitors can also determine a stillbirth. During labour and delivery, stillbirth is usually diagnosed after the baby has left the birth canal.

What Happens After Diagnosis of a Stillbirth?

After a woman has been diagnosed with a stillbirth, she can choose whether or not to have labour induced. It is perfectly safe to wait for labour to occur naturally, and this typically occurs within two weeks of fetal death. However, the emotional pain of carrying a stillborn baby is often too great to wait for natural labor. As a result, many women opt to have their labour induced. Your health care provider will insert suppositories into your vagina to stimulate cervical dilation. You will also receive the hormone oxytocin to help stimulate uterine contractions. If you encounter problems delivering your baby, a cesarean section may be performed in order to prevent any serious health complications.

Finding Out What Went Wrong

A stillbirth is an emotionally devastating event for any parent. Though it may seem difficult at the time, it is important for health care providers to examine your baby in order to attempt to find a cause for the stillbirth. Blood tests and a post-mortem examination will be performed, along with an examination of your placenta. These tests can also help to predict whether or not you may face future problems with stillbirth. The vast majority of couples experience healthy pregnancies after stillbirth, although parents with genetic defects or illness may be at increased risk for subsequent stillbirths. Also find out more about recurrent stillbirths and learn more about doctors and still birth.

Stillbirth Prevention

Thanks to increased knowledge and better treatment of maternal conditions, the number of stillbirths occurring every year is rapidly dropping. To help decrease your risk of experiencing a stillbirth even further, here are some steps that you can take:

• Attend all Prenatal Appointments: It is important to attend regular prenatal appointments throughout your pregnancy. During these appointments, your caregiver will check to make sure your baby is developing properly and that your placenta is healthy and of normal size. Regular prenatal appointments can also help to identify any additional health problems early on.
• Monitor Baby’s Movements: After the 26th week of pregnancy, it is recommended that all pregnant women monitor their baby’s movements. Count the number of kicks that your baby makes every day. If your baby is kicking less than ten times a day, or seems to be abnormally quiet, consult your health care provider.
• Avoid Infection: Many infections responsible for stillbirth are preventable during pregnancy. Avoid handling cat litter, as there are several cat health problems, during pregnancy, and don’t eat raw or improperly cooked foods. Get tested for STDs, including chlamydia, gonorrhea, and syphilis, early in pregnancy.
• Report Pain or Bleeding: Monitor yourself for any abnormal bleeding or pains during your pregnancy. Report any of these symptoms, no matter how minor, to your health care professional.