Stillbirth (Stillborn Baby)

What is stillbirth vs. miscarriage? Can you have a healthy pregnancy after a stillborn baby?

Stillborn (stillbirth) means the death of a baby before birth. This can occur before or during the delivery of the baby. About 1% of pregnancies overall result in stillbirth, meaning that there are about 24,000 stillbirths each year in the U.S.

Both stillbirth and miscarriage are forms of pregnancy loss. In the U.S., a pregnancy loss before the 20th week of pregnancy is referred to as a miscarriage, while the term “stillbirth” refers to the loss of a baby after 20 weeks gestation. Not all doctors agree worldwide on these terms; for example, the WHO (World Health Organization) recommends a stillbirth be defined as a baby born with no signs of life at or after 28 weeks gestation.

Stillbirth can be described as early, late, or term, depending on the stage of pregnancy.

• An early stillbirth is a fetal death occurring between 20 and 27 weeks of pregnancy.
• A late stillbirth is a fetal death occurring between 28 and 36 weeks.
• A term stillbirth is a fetal death occurring at 37 or more weeks.

The most common symptom of stillbirth is not feeling the baby moving or kicking. In some women, cramps, pain, or vaginal bleeding may also occur.

Since stillbirth is defined as the death of a baby in the womb, a stillborn baby cannot survive. While medical intervention is needed to deliver the baby, when a baby is stillborn, it has no chance to survive.

A number of diseases and conditions as well as problems with the pregnancy or health of the mother can all be causes of stillbirth.

Some causes of stillbirth include:

• birth defects or chromosomal abnormalities in the fetus;
• problems with the placenta, such as insufficient blood flow;
• infections of the fetus, mother, or placenta;
• complications of pregnancy and labor, such as preterm labor and placental abruption (separation of the placenta from the uterine wall);
• problems with the umbilical cord; and
• high blood pressure or other health complications in the mother.

Certain conditions or factors increase the risk of having a stillborn baby, such as:

• Obesity
• Diabetes or high blood pressure
• Multiple gestations
• Age under 20 or over 35
• Black race
• Smoking
• Alcohol use
• Drug abuse
• History of stillbirth, miscarriage, or pregnancy complications

Stillbirth can be diagnosed by ultrasound examination to show that the baby’s heart is no longer beating. After delivery, the baby is found to be stillborn if there are no signs of life such as breathing, heartbeat, and movements.

Treatment for mothers of stillborn babies includes several key components:

• Delivery of the fetus. Depending on the stage of pregnancy, the fetus may be delivered by induction of labor or by dilation and evacuation (dilation of the cervix and removal of the fetus from the womb) if the stillbirth occurs in the second trimester. Cesarean delivery may also be an option for some women.
• Examination of the fetus and search for causes of stillbirth. This can include an examination of the fetus or the amniotic fluid to try to determine the reason for the stillbirth. It is important to do this to try to determine if some conditions or factors might place future pregnancies at risk.
• Management of risk factors. If medical reasons or risk factors are present that might put future pregnancies at risk, the mother can work with her healthcare team to try to minimize the risk for future pregnancies.
• Coping with grief. Emotional support and grief counseling are other important parts of the treatment of the mother.

While there is never a way to prevent stillbirth completely, you can take steps to reduce your risk and to ensure a healthy pregnancy, such as maintaining a healthy weight before getting pregnant, not smoking or using alcohol or other drugs, getting a thorough checkup before becoming pregnant, ensuring good prenatal care and medical supervision, and getting treatment for any medical conditions.

Most women who have a stillborn baby go on to have a healthy pregnancy. The chances for a repeat stillbirth are very low. Only about 1 in 100 women (1%) will have a repeat stillbirth.