Stillbirth: Trying To Understand

According to the National Stillbirth Society, stillbirth is defined as the intrauterine death and subsequent delivery of a developing infant that occurs beyond 20 completed weeks of gestation. A stillbirth occurs in about 1 in 160 pregnancies. The majority of stillbirths happen before labor, whereas a small percentage occur during labor and delivery.

Why do stillbirths happen?

If you have had a stillbirth or are supporting someone through this difficult experience, you probably are in desperate need of knowing why this happened. An autopsy is normally the best way to diagnose a cause for stillbirth, but this is not always a standard procedure. Inquire about your hospitals’ procedures when handling stillborn babies and the cause of death. If a normal procedure is not to have an autopsy, seek to find out how you can request if that’s what you and your family desire.

The Most Common Known Causes Include:

  • Placental Problems: Women with placental abruption or a pregnancy-related form of high blood pressure called preeclampsia or pregnancy-induced hypertension, have twice the risk of abruption or stillbirth as unaffected women. Sometimes insufficient oxygen and nutrients can also contribute to a baby’s death.
  • Birth Defects: Chromosomal disorders account for 15-20% of all stillborn babies. Sometimes a baby has structural malformations that are not caused by chromosomal abnormalities but can result from genetic, environmental or unknown causes.
  • Growth Restriction: Babies who are small or not growing at an appropriate rate are at risk of death from asphyxia (lack of oxygen) both before and during birth, and from unknown causes.
  • Infections: Bacterial infections between 24 and 27 weeks gestation can cause fetal deaths. These infections usually go unnoticed by the mother and may not be diagnosed until they cause serious complications.
  • Other infrequent causes of stillbirth include: umbilical cord accidents, trauma, maternal diabetes, high blood pressure and postdate pregnancy (a pregnancy that lasts longer than 42 weeks)
  • Unfortunately, despite efforts to find out why, the cause can not be determined in about one-third of stillbirths.

What are some factors that increase a mother’s risk of stillbirth?

  • Women 35 years old or older
  • Malnutrition
  • Inadequate prenatal care
  • Smoking
  • Alcohol and drug abuse
  • African-American ethnicity

How is a diagnosis made?

Most women usually notice that their baby isn’t very active and become worried about what this could mean. An ultrasound can confirm that the baby has died and in some cases determine the reason why.

Can stillbirth be prevented?

Improvements in medicine have decreased the number of stillbirths. Today women with high-risk pregnancies are carefully monitored through routine ultrasounds and/or fetal heart rate monitoring. If potential problems are identified, early delivery may be necessary.

The following are steps you can take to help prevent stillbirth:

  • A daily “kick count.” Starting at 26-28 weeks of pregnancy, take time each day to record your baby’s movements. If you familiarize yourself with what is normal for your baby, then you are more likely to notice when something does not feel right. If you notice a sudden decrease in movements, contact your health care provider. An ultrasound can normally confirm if there are any potential problems.
  • Avoid drugs, alcohol, and smoking as these can increase your risk of stillbirth and other pregnancy complications. Contact your health care provider immediately if you have any vaginal bleeding in the second half of pregnancy.
  • If you have had a previous stillbirth, future pregnancies should be monitored closely so that all necessary steps can be taken to prevent another pregnancy loss.

Compiled using information from the following sources:

1. National Stillbirth Society

2. March of Dimes,