What Is Still Birth? Causes, Preventions, Evaluations & After Still Birth Guidelines

Medically reviewed by Maria Sarino, MD FACT CHECKED

Stillbirth could be one of the saddest moments of a woman’s life. It may take a serious toll on the health of the woman and her family. The meaning of stillbirth is the death of a baby in the womb of the mother after the 20th week of pregnancy.

However, another term known as miscarriage may be synonymous with stillbirth. But they differ based on the time duration when the loss occurs.

In the United States, the meaning of miscarriage is the loss of the baby before the 20th week of pregnancy. On the other hand, stillbirth is the loss of a baby after the 20th week of pregnancy.

As we all know, prenatal care has comparatively improved over the years. However, stillbirths are still a reality and might happen due to certain as well as uncertain reasons. The death of the foetus after the 20th week of the pregnancy or stillbirth might be classified into three types-

  • Early Stillbirth

    The foetal death occurring between 20-27 completed weeks of pregnancy is referred to as early stillbirth.

    More info here.

  • Late Stillbirth

    When the foetus dies between 28 to 36 weeks of pregnancy then it is termed as late stillbirth.

    Here is a one article from ncbi.

  • Term Stillbirth

    The death of the foetus on the 37th week or after that is referred to as the term stillbirth.

    Preventions of term still birth are discussed here.

According to different researches, the baby might be stillborn in approximately one out of 200 pregnancies.

However, the researches even show how the women who have a stillbirth might be able to give birth to a healthy baby in their consequent pregnancy.

If the major reason behind the stillbirth was issues related to the umbilical cord or chromosomal problems, then the chances of stillbirth happening again are quite small.

On the other hand, if the causes were related to a genetic disorder in the parents or the chronic illness of the mother, then the risk of stillbirth might be higher.

However, generally, the chances of success of future pregnancies are 90%.

More on it here.

Causes of Stillbirth

Different causes might augment your risk for stillbirth.  By knowing the risk factors related to stillbirth you might prevent them. However, you might not be able to change some of the risk factors of stillbirth like the medical conditions. But you could change other risk factors like quitting smoking.

According to studies and researches conducted by the Centres for Disease Control and Prevention, some of the risk factors or causes for stillbirths are as follows-

  1. Medical Conditions

    • Diabetes. When you have diabetes, your body might have too much glucose or sugar in the blood, which could become a cause for stillbirth.
    • Substance abuse. The presence of certain harmful substances in your body might bolster the risk of having a stillbirth. Say, for example, consuming alcohol, smoking and using street drugs or painkillers like opioids.
    • Obesity. Obese people have an excess amount of fat in their bodies. The BMI of obese people may generally be 30 or even higher. BMI is a measure that helps to assess body fat using weight and height.
    • High blood pressure. Blood pressure refers to the pressure exerted by the blood when it pushes against the wall of the arteries or blood vessels. Arteries carry blood from the heart to the other organs of the body. So high blood pressure may also be considered as a medical risk factor for stillbirth.
  2. Pregnancy Conditions

    • There could be a chance of stillbirth when you may suffer from Intrahepatic Cholestasis of Pregnancy (ICP).ICP is a liver condition that might develop during pregnancy.
    • Another pregnancy condition where the chances of stillbirth are higher is when you might be pregnant with multiples like twins, triplets or even more.
    • Some researchers have even shown there is a greater reported risk of stillbirth in unmarried people. The researchers think that stillbirth between unmarried people may be linked to the less social support provided to the unmarried people the major reason or risk for stillbirth here could be social support.
    • If you had complications in your previous pregnancy, then the risk of stillbirth might be higher in the next pregnancy. The complications could include foetal growth restriction, pre-eclampsia or preterm birth. Foetal growth restriction is a condition when the baby does not have enough weight when he or she is in the womb of the mother. On the other hand, pre-eclampsia is a condition when the pregnant lady might face failure in some of the organs like liver kidneys along with high blood pressure. Preterm or premature birth is a birth that happens before 37 weeks of pregnancy.
    • If you had faced miscarriage or stillbirth in your previous pregnancy, that there might be a chance for stillbirth now.
    • According to research conducted by the American College of Obstetricians and Gynaecologists, there might be an augmented risk of stillbirth in case you are pregnant after the age of 35. These researchers show how the risk of stillbirth increases in people older than 35 years due to chromosomal conditions.
  3. Chronic Stress

    According to several studies, chronic stress that has been caused due to racism or living in a racist culture might even be a risk or cause for stillbirth.  However, other studies show how this chronic stress is caused due to race. So there could be a chance that the direct risk factor of stillbirth might be the race.

  4. Racism And Health Discrepancies

    Sometimes stillbirth might also be due to health disparities or differences. You could understand this by assessing the social factors that might affect stillbirth. Different conditions where you are born, grow, age and live might affect your health throughout your life. So the social factors of health might even be related to racism sometimes.

    Racism refers to personal attacks like bullying or physical assault, along with a racist culture where one group of people is generally more powerful than the other. So the group of dominant people might make all the important decisions. They may live in safer environmental conditions and may have access to better education and job opportunities.

    On the other hand, people from the racial minority group might live in an unsafe neighborhood and may experience augmented levels of chronic stress. They might even have limited access to better education, healthy foods, fruits, and even well-paying jobs.

Detailed references

  1. NICHD
  2. Medline Plus
  3. NCBI

Symptoms Of Stillbirth

There are a number of symptoms that you may see before your miscarriages or stillbirths occur. You could face spontaneous abortions or even incomplete abortions.

In incomplete abortions, the heartbeat of the infant may stop. However, at the same time, the pregnancy stays in the uterus. So, you may need the support of a healthcare professional to surgically get free of the fetus.

Another type of stillbirth could be a threatened abortion or threatened stillbirth that might be seen with the symptoms of sudden bleeding.

However, sometimes it may even happen that you may not face any symptoms at all before stillbirth. So once you come to know about your stillbirth, you should take time to read and process the information in the best possible way.

Then later, you may make your decision about how to proceed further.
Though the possibility for stillbirth is 1 %, it could happen either with symptoms or even without any explanation.

You might want to call your doctor immediately when and if you feel any of these symptoms for the checkup and stillbirth care.

How To Find Out The Major Cause Behind Stillbirth?

You could discover the major reason behind stillbirth by getting the following tests performed-

  • Blood tests. The blood tests might help the doctor to know whether you had diabetes, pre-eclampsia or obstetric cholestasis.
  • Thyroid function test. Under this test, your doctor could easily know if there was an issue with your thyroid gland or not.
  • Analysing the Placenta, umbilical cord and membranes. The Placenta, umbilical cord and other membranes are the tissues that help to connect the foetus. So if there is any problem in these tissues then it could be a reason for the stillbirth. Any such issue might not let the necessary nutrients, blood and oxygen reach the foetus.
  • Genetic tests. You could know the genetic problems of your baby by letting your doctor take a sample of the umbilical cord. If your baby has certain genetic problems like down’s syndrome, then it might be the cause for the stillbirth.
  • Tests for infections. There are several tests for infection. Your doctor could do these tests by taking a sample of your urine, blood, or cells from the cervix or vagina.

Besides the different tests, the doctor might even analyse your situation and the medical records. An autopsy could even help to determine the exact cause of the stillbirth.

How Common Is Stillbirth?

Generally, it may be difficult to tell how common is stillbirth. However, typically if you become pregnant a number of times, then your chances of a miscarriage or stillbirth may bolster.

In such cases, a lot of times you may suffer miscarriage even before you know that you are pregnant. The rates of miscarriage or stillbirth may range somewhere between 20 to 25% or sometimes even higher.

Since there are a plethora of causes that might augment your risk of facing a miscarriage or stillbirth, it is difficult to determine the frequency of stillbirths.

However, miscarriages occurring in single women may be quite common. Moreover, age is even a crucial factor that decides fertility. The paternal chromosomes in the males may differ as he ages, and may even heighten the risk of miscarriages or stillbirths.

Risk Factors Of Stillbirth

Though there are very rare cases of stillbirth, their risk is never 0. Some of the surveillance and testing may help to prevent stillbirth. However, the major cause that determines whether stillbirth can be treated or not is the root cause of the stillbirth. There are a number of risk factors that could augment your chances of stillbirth.

  • The first risk factor that might heighten your chances of stillbirth is gestational age. Generally, there is a misconception that as your baby ages or you move towards your due date, the chances of stillbirth may truncate. However, this is just a myth. The chances or risks of stillbirth might augment at the end of 34 weeks.
  • The next risk factor that decides your risk for stillbirth is maternal age. You could find a dramatic increase in stillbirth as you age. Hence the pregnant ladies that are more than 35 years old might face a higher risk of stillbirth. At the same time, people who are below 15 might even face a higher chance of stillbirth. So, the best age that could help to minimize the risk of stillbirth might range somewhere between 25 to 29 years.
  • Another risk factor of stillbirth could relate to ethnicity. When black people are compared to white people, they may have a comparatively higher risk for stillbirth.

Besides the above-mentioned risk factors, there are other risk factors as well.

Such risk factors may include obesity levels, alcohol usage, smoking, hypertension, diabetes, previous stillbirth, previous growth-restricted infant, or even multiple gestations.

Here are some of the stuff that you should avoid during pregnancy.

More detailed info here.

What Happens After Stillbirth?

If your baby dies before you are in labour then you could choose three options. These child delivery options are explained below.

  1. Induced Labour

    The doctors say that induced labour might be one of the best options after stillbirth. They might go for this option immediately if the mother suffers from the following conditions.

    • Serious infection.
    • Extreme preeclampsia
    • Clotting disorder
    • Broken amniotic SAC

    So the doctors may opt for induced labour in all the above-mentioned conditions. They could induce labour using medicines in any of the five ways mentioned below.

    • The doctor might get a gel inserted into your vagina.
    • The doctor may use the technique of a foley bulb. A Foley bulb is a mechanical balloon that could widen your cervix.
    • The doctor may even insert a tablet into your vagina.
    • The doctor may induce labour by giving you a swallowed tablet.
    • Another method is a drip into a vein.
  2. Natural Birth

    Another option for you when your baby may pass away is natural birth. You could wait for the birth to happen naturally. However, since you wait in the process of natural birth, your baby might look quite different than what you must have expected due to deterioration. Moreover, the waiting period might also make it difficult for the doctors to figure out the real cause of the death of the baby.

  3. Cesarean Section

    A cesarean section or C-section might not be recommended by the doctors. The reason behind this is because it is not as safe as compared to the other two methods- induced labour and natural birth.

Final Words On Still Birth

When you lose a baby due to stillbirth, then you might experience feelings of grief and emotions. So you should follow certain tips and techniques that could help to prevent stillbirth. You may keep track of your babies at different times of the day.

Keeping the track of the movement of your baby might even be more important in the 26th week. If you feel that your baby shows less activity, then you might consult your doctor.

Another method to prevent a stillbirth is to wait for some time before getting pregnant after a stillbirth.  Researchers have shown that the women who got pregnant after 12 months of their stillbirth had augmented levels of depression and stress.

Moreover, it is very important to take good prenatal care of yourself. So, you should be regular with your doctor appointments. Your husband should also take care of you during and after your second pregnancy.

Leave a Reply

Your email address will not be published. Required fields are marked *