When the death of a baby happens after 20 weeks gestation, but before birth, it is called a stillbirth. A fetal death before 20 weeks is termed a spontaneous abortion, or miscarriage. Stillbirth happens in about 5 in 1000 pregnancies. Stillbirth is classified into early, late, or term stillbirth:
In many cases, the cause of stillbirth is not known. In general, the causes of stillbirth are related to a problem with the baby, the placenta or umbilical cord, or a serious health condition in the mother. Some factors that increase the risk of stillbirth include:
If the cause of the stillbirth is unknown, there are investigations that can help find a cause or rule out some of the possibilities.
What to do after a stillbirth is an individual decision. Some families want to see and hold the baby and others prefer not to. Some families find comfort in creating memories with their baby such as footprints, handprints, and photographs. There is no right or wrong way to respond to this heartbreaking event and it’s fine to take some time to make choices that are right for you in the aftermath of a stillbirth. Many hospitals have religious representatives if a family would like to observe a religious ritual or religious support. Investigations into the cause of the stillbirth will also be conducted, such as autopsy, placental pathology, and genetic testing.
Experiencing stillbirth can be traumatic and coping with the pain of loss can be difficult. It is common for women and families who have experienced stillbirth to struggle with depression, post-traumatic stress, and/or anxiety. Your health care provider will arrange grief counselling for you and your family. There are many organizations that offer support to women who have had a stillborn infant (see below). There are also grief resources in many communities, where you can access in-person support from other parents who have gone through the same thing. Finding a way to keep your baby’s memory alive like celebrating your baby’s memory with a memorial or making donations to support research can be helpful. Every woman and family will experience the loss differently and coping strategies are different too.
Women who have had a stillbirth can go on to have a healthy baby in the future. However, if you have had a stillbirth, there is an increased risk of stillbirth in subsequent pregnancies. There is also an increased risk of preterm birth, low birth weight, and placental abruption. The baby’s growth and development will be monitored carefully. Low-dose aspirin may reduce the risk of another stillbirth if the cause of that stillbirth was placental insufficiency. Decisions around the timing of the birth will require consideration of the circumstances of the previous stillbirth, and the drawbacks of delivering prior to 39 weeks gestation.