What is stillbirth?
The medical definition of stillbirth is the birth of a baby who is born
without any signs of life at or after 24 weeks pregnancy. The baby may
have died during pregnancy (called intrauterine death), labour or birth.
Stillbirth is uncommon. In the UK, just over one in 200 births ends in
What happens when a baby dies in the uterus?
When a baby dies in the uterus (womb), the sad truth is that the mum
still has to go through with the birth. The loss of your baby will have
come as a great shock. You may not be thinking about yourself at all,
but doctors still have to advise you about what's best for your health.
They will be sensitive to your feelings while explaining what happens
next. Your labour will usually have to be started artificially (induction
Your doctors will discuss this with you and give you time to absorb
what they have said before starting to induce your labour.
Some parents want to have the induction as soon as possible. Others
prefer to wait for a few days so that they have time to take in what has
happened and to see if labour starts by itself.
You may feel too numb to make a decision. All the while, your doctors
will be concerned about your health. If they think there's a chance you
may have an infection, they'll advise you to have an induction straight
away. Whether you are induced or go into labour naturally, you will be
admitted to the labour ward at hospital.
If you are expecting twins or more, and the death of one baby has been
discovered, your doctor may advise you not to be induced. A lot will
depend on whether or not the babies share a placenta, and at what stage
the loss occurred. Your doctor may say it's best to give your other baby
or babies a chance to develop and mature a bit longer in your uterus.
Your babies can then be born at the same time, when it's best for your
remaining, healthy baby or babies. Some parents are upset by the idea of
carrying the babies together in this way, although others find it
What happens when a baby dies during birth?
It's uncommon that a baby dies unexpectedly during labour or birth. When
something goes wrong, it is a traumatic and frightening experience for
parents. They may not understand what is going on, as hospital staff may
be too busy dealing with the emergency to explain things clearly.
Later, it may be discovered that an abnormality or an infection led to
the stillbirth. However, in most cases it's because of something that
happened during labour or birth. A problem with the placenta or
umbilical cord, such as a knot in the cord, may mean the baby did not
have enough oxygen.
What causes a baby to be stillborn?
It's not always possible to find out what has led to the death of a
baby. It's the one question that parents want answered, why their baby
died. Unfortunately, in just under a third (28 per cent) of cases,
doctors cannot tell them.
However, we do know of some factors that may lead to stillbirth:
- A baby simply did not grow enough in the uterus.
- A genetic or physical defect in the baby. This means the baby's brain, heart or other organ has not developed properly.
- Heavy bleeding after 24 weeks of pregnancy. This can happen when the
placenta begins to separate from the lining of the uterus. It is called
a placental abruption.
- Pre-eclampsia, which can reduce blood flow to the baby via the placenta. This condition is associated with placental abruption.
- An illness suffered by the mum, such as diabetes, the liver condition obstetric cholestasis, or a blood-clotting problem.
- A problem with the way the baby is born. A baby's shoulders may get stuck as he leaves the birth canal (shoulder dystocia), severely reducing oxygen flow to him.
- Infections, such as listeriosis, salmonella or toxoplasmosis.
Many stillborn babies are premature or smaller than they should be
for their stage of pregnancy.
What happens after a baby is stillborn?
You may be asked if you would like to see, touch or hold your baby. This
is a highly individual decision. Some parents may find it a help in the
longer term to see their baby, others not.
Your instincts may be to see and cuddle your baby, but worries about
what he or she might look like could hold you back. To help you to
decide what is right for you, the midwife or doctor can describe your
baby to you. Maybe one partner could look first, or you and your partner
could look at a photograph of your baby. Some people know instinctively
that they don't want to see their baby, while others choose not to for
religious or cultural reasons.
Many parents find comfort in creating memories
of their baby. Photographs, hand or foot prints or a lock of hair
become cherished keepsakes, giving parents a focus for their grief. Some
parents want to wash and dress their baby. These are overwhelming,
natural instincts. However, sadly, it's not always practical for this to
happen. If a baby is very premature or died some time ago, his skin
will be too fragile for this type of handling.
Decisions about what to do in this situation are very personal. There is
no right or wrong way to respond. One parent may have different wishes
to the other, or they may both need time to think about what would be
best for them.
Some parents or members of their family want to observe religious
rituals to mark the loss of the baby. Lighting a candle is unlikely to
be possible in hospital, but other religious items may be brought in.
Hospitals have their own chaplains, some with multi-faith
representatives, who can offer spiritual support.
Most maternity wards have a bereavement room or quiet room where parents
and their families can be together after their loss. Others may prefer
to visit the hospital chapel or a multi-faith room. Whatever you
ultimately decide to do in the hours or days after your loss, the
hospital staff should support you in your decision and respect your
wishes. Some hospitals have a bereavement midwife who is specially trained to give support.
You may want to read our article about the practical arrangements
that need to be made after the loss of a baby.
Is it possible to find out what went wrong?
If doctors aren't sure what caused a baby’s death it can sometimes be
discovered by various investigations. These may include testing the
mum's blood, examining the placenta, or carrying out a post mortem
examination (autopsy) of the baby. A post mortem examination may:
- identify a cause or causes of death
- provide information about your baby’s development
- provide information about health problems which will help your doctor to care for you in a future pregnancy
- confirm the baby’s sex
Not all parents agree to tests and a post mortem. It's up to you whether
you give the go-ahead. A post mortem will only be done with your
You can refuse for whatever reason you like, be it personal, religious
or cultural. Sometimes, even with these investigations, a reason for
stillbirth cannot be found. It can be very upsetting not to have an
answer to all your questions. It's hard to come to terms with how such a
devastating event can happen, apparently for no reason.
You should be given plenty of information about the post mortem. Doctors
will tell you why it may help, what will happen to your baby and how he
may look afterwards. Do make it clear if you'd rather not know the
details. You may decide you want to say goodbye to your baby before the
post mortem. But in many cases, you'll be able to see your baby again
afterwards, if you want to.
The important thing is to take time over your decision, and be sure
about how and when you want to say goodbye to your baby. Whatever you
decide about the post mortem, your views and wishes should be respected.
If you go ahead, you should be told when the results are likely to be
available. You'll be given an appointment to discuss them with your
I can't cope with the loss of my baby. Where I can I find help?
People cope with the trauma of losing a baby
in very different ways.
You may feel that you want to get back to normal as quickly as
possible. On the other hand, you may want to withdraw from normal life
for a long spell to mark your loss. It may help to read our understanding grief after loss
You may also find it helpful to contact the charity, Sands
, for support or find people who have been through a similar experience in the BabyCentre community
It can be hard to cope physically, too. Your body itself will be
constant reminder of your loss. You'll have vaginal bleeding and your
breasts will produce milk, which can be particularly distressing. Read
more about easing yourself through these physical changes and getting your strength back after loss
What does it mean for my next pregnancy?
The decision to try for another baby can be difficult. It may be the
last thing on your mind, or it may be all you can think about. For some
mums, there is an overwhelming urge to be pregnant again as soon as
You will be offered a check-up six weeks after your previous pregnancy
ended. It will take place at the hospital with a consultant
obstetrician. This is a good chance to ask questions that have occurred
to you now you've had time to think. If you're ready to talk about it,
it also gives you a chance to discuss trying for another pregnancy.
Waiting a while, perhaps six months or so, before trying to conceive
again gives your body a chance to recover. Because of this, it may also
give your next baby a good start. Some parents wish to plan their next
pregnancy so that none of the significant dates coincide with those of
the baby they're grieving for.
If you've had an unexplained stillbirth, it may be comforting to know that there's no reason why it should happen again.
If your baby had a genetic abnormality you may be referred for genetic
counselling. This process will enable you to discuss your options for a
If you had health problem last time then you and your doctor may be able
to work together to reduce your risk of another stillbirth. This is
especially the case if there was a problem with the placenta or your
baby's growth. Extra monitoring and tests can reduce the chance of you
experiencing another loss. If you do get pregnant again in the future,
it's likely to be an anxious time for you. It may bring back lots of
unwelcome memories and emotions related to your loss.
Some mums are happy to return to the same hospital and the same medical team. Others prefer to ask their GP
to refer them to another consultant or another hospital. Ask whether
your hospital offers extra support to parents who have had a previous