It is every pregnant woman’s worse nightmare – getting to the last weeks or months of your pregnancy and being excited to meet your much anticipated new baby, only to find out that their heart has stopped beating. Stillbirth is defined as the loss of a baby that occurs after 20 weeks of pregnancy, and is further divided into:
- Early stillbirth (occurring between 20 and 27 weeks of pregnancy)
- Late stillbirth (occurring between 28 and 36 weeks of pregnancy)
- Term stillbirth (occurring between 37 or more weeks of pregnancy).
However, luckily stillbirth is relatively uncommon, affecting around 1 in 160 pregnancies, with approximately 80% of these stillbirths occurring before 37 weeks.
Common signs and symptoms of stillbirth
Stillbirth can often occur without any symptoms. However, one of the most common symptoms of stillbirth past 28 weeks is a lack of movement of the fetus. This is why doctors often ask women to track fetal kick counts from this point onwards. Although it is good to remember that babies have days when they are more active than others, you should trust your instinct. If you baby feels less active to you, trust your gut and call your healthcare provider. Increased fetal activity can also be an indicator that something is wrong with the fetus. In 2016, a study found that a noticeable increase in vigorous activity was sometimes associated with stillbirth. So if you notice a big increase in the strength and frequency of your baby’s movements, also call your healthcare provider.
However, it is also good to remember that most changes in activity are quite normal and so try not to put yourself under too much stress with kick counts.
Other common signs and symptoms of stillbirth include:
- Spotting or bleeding from the vagina
- High fever
- Mild-to-severe abdominal cramps
- No detection of heartbeat
Causes of stillbirth
Causes of stillbirth include:
- Placental problems such as placenta previa
- Fetal abnormality.
Another cause is an insufficient placenta, when the placenta is not providing adequate oxygen or nutrients to the fetus. This can be an inherent issue with the placenta or can be due to the placenta getting too old. The placenta starts to break down after around week 38, this is thought to be a reason that prolonged pregnancies (more than 40 weeks) have an increased risk of stillbirth. This is particularly the case after 42 weeks, where the risk of stillbirth is twice as high as it is at term. In addition, prolonged pregnancies are thought to be responsible for 14 percent of stillbirths.
Risk factors for stillbirth
Although stillbirth can happen to anyone regardless of income, ethnicity, or race, certain women are at higher risk for having a stillbirth. Some of these risk factors include:
- Being a teenager
- Being 35 years of age or older
- Being obese
- Smoking cigarettes during pregnancy
- Having multiple pregnancies
- Having experienced a previous pregnancy loss
- Having certain medical conditions such as uncontrolled diabetes or uncontrolled blood pressure
So, before you get pregnant, it would be worth losing some weight if you have a weight issue or getting your diabetes or blood pressure under control. And of course, stopping smoking during pregnancy is very important, not just for preventing stillbirth. For women who have risk factors that are not able to be changed, such as age and previous pregnancy loss, your healthcare provider should be monitoring you particularly closely.
Sometimes a stillbirth is able to be prevented through monitoring but unfortunately other times this isn’t possible. As part of prenatal care, you and your baby will be monitored for early signs of problems and if you have a high risk of stillbirth, consultation with a perinatologist or an obstetrician who specializes in high-risk pregnancies should be considered.
How to cope with a stillbirth
If you have experienced a stillbirth you already know that coping is easier said than done. You might be blaming yourself, even though the stillbirth was not likely to be your fault, and you might be struggling to understand what happened. Stillbirths can be particularly hard for you as the mom, as you will also be dealing with issues such as breast engorgement and recovering from the birth.
It is very important to remember that it’s okay to grieve. You’ve gone through one of life’s toughest experiences – that of losing a child. Many parents feel a deep bond with their baby long before birth and to have that bond severed is understandably traumatic. Many women find that writing in a journal or going to support groups can help with the grieving process. There are several support groups for pregnancy loss out there that can help you with the grieving process. These include:
- Share Pregnancy And Loss Support
- March of Dimes
- International Stillbirth Alliance
- The Miscarriage Association
- Helping After Neontal Death (California-based)