What is stillbirth?
Stillbirth is a common term for death of a fetus after 20 weeks. It is also called intrauterine fetal death or demise. Causes of stillbirth may include the following:
Mother with diabetes or high blood pressure
Infection in the mother or in the fetal tissues
Rh disease. A blood incompatibility problem between the mother and fetus.
Cord problems including knots, tightened cord, cord wrapped around fetal body or neck, cord prolapse (falling down through the open cervix during labor)
Placental problems including poor circulation, twin-to-twin transfusion (when twin circulations connect in a shared placenta)
What are the symptoms of stillbirth?
The following are the most common symptoms of stillbirth. However, each woman may experience symptoms differently. Symptoms may include:
Stopping of fetal movement and kicks
Spotting or bleeding
No fetal heartbeat heard with stethoscope or Doppler
No fetal movement or heartbeat seen on ultrasound, which makes the definitive diagnosis that a baby is stillborn. Other symptoms may or may not be linked to stillbirth.
The symptoms of stillbirth may resemble other medical conditions. Always consult your doctor for a diagnosis.
Treatment of stillbirth
Treatment of stillbirth depends on many factors such as the number of weeks gestation, the size of the fetus, and how long since the fetal heartbeat stopped. Treatment may include the following:
Waiting until the mother goes into labor on her own
Dilating the cervix and using instruments to deliver the fetus and tissues
Induction of labor using medications to open the cervix and make the uterus contract and push out the fetus and tissues
Why is stillbirth a concern?
Stillbirth is often very difficult for parents and other family members. It is sometimes harder than an earlier miscarriage because it happens later in pregnancy when the fetus has developed and the mother has felt movement. Often, the fetus is fully formed and is delivered just as any baby. It may be very hard emotionally for a woman to go through labor, yet not have a baby to take home. Counseling is important for all parents with a stillbirth to help them understand their feelings and begin the work of grieving.
Grieving the loss of your child
Mementos of the baby often help in the grieving process. Holding and touching the baby are important steps. In a private room, a nurse or counselor brings the baby to the parents wrapped in a blanket. This helps parents understand that the baby has really died and gives them a real, not imagined memory. Seeing the baby is especially helpful when a baby has a birth defect. Often, parents' imagination of the defect is much worse than the real problem. Photographs of the baby may be helpful, too, as well as a lock of hair or footprints. Many parents wish to remember their baby with a memorial or funeral service. This can also help friends and other family members understand the loss that the parents have experienced.
Some parents may wish to learn more about the cause of their baby's death, especially if there are no clear factors. An autopsy or special genetic and chromosomal testing are often available. Results can be shared with the parents at a meeting with your doctor several weeks afterwards. Autopsy does not prevent the parents from being able to see or hold the baby, and the autopsy can be performed before a funeral, if the parents wish.
- Grantham, Paula, RN, BSN
- newMentor board-certified, academically affiliated clinician