A stillbirth happens when the fetus dies after week 20 of pregnancy. Stillbirths can have multiple causes, including problems with the placenta or umbilical cord, genetic conditions that affect the fetus or pregnancy complications. There are resources available to support you through a pregnancy loss.
A stillbirth is when a fetus dies after the 20th week of pregnancy. Many people imagine a stillbirth as a single moment when a baby’s born with no heartbeat. But most stillbirths happen in the uterus. Although it happens, the fetus rarely dies during labor. In most cases, providers diagnose the loss beforehand and take steps to intervene well before the due date.
A stillbirth is a jarring pregnancy loss, similar to a miscarriage. Stillbirths involve fetal death after week 20, while miscarriage involves the fetus passing away before week 20. Like a miscarriage, a stillbirth is a traumatizing event that may require lots of time and a strong support network to grieve.
Healthcare providers classify stillbirths based on the number of weeks of pregnancy before the fetus passes.
Stillbirth rates vary significantly depending on the part of the world. Developing countries have as many as 22 stillbirths out of every 1,000 births. The rate is much lower in developed countries. For example, the U.S. has approximately 6 stillbirths for every 1,000 births. In the U.K., there are about 3.5 stillbirths for every 1,000 births.
Improved prenatal care has led to reduced rates of stillbirths worldwide. But there’s a long way to go to reduce healthcare disparities (differences) that make some people more likely to experience stillbirths than others.
A stillbirth can happen during any pregnancy. But health, lifestyle and environment all shape the risks associated with pregnancy loss.
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In 1 in 3 stillbirths, healthcare providers don’t know why the fetus passed. Causes can be complex. Issues primarily affecting the mother (gestational parent), the fetus, or the tissues and organs connecting them can all lead to stillbirth.
Infections from a virus, parasite, bacteria or another pathogen (germ) cause up to 50% of stillbirths in developing countries. They cause up to 25% of stillbirths in developed countries. Sometimes, the infection doesn’t cause symptoms, so you don’t know there’s an issue until a pregnancy complication happens.
Access to high-quality prenatal care can often reduce the risk of stillbirths related to infections.
Theplacenta is an organ that allows you to share nutrients with the fetus via the umbilical cord. A problem with these lifelines can prevent the fetus from receiving the oxygen, blood and nutrients needed to thrive.
Placental abruption is when the placenta separates from your uterus. It’s responsible for 10% to 20% of all stillbirths. A twisted umbilical cord can lead to a stillbirth if it prevents the fetus from getting enough oxygen. It causes up to 10% of stillbirths.
Sometimes, there’s an issue with how the fetus develops, or a congenital disability (birth defect). The fetus may have a genetic condition.Genes contain the instructions that tell the fetus’s body how to grow and work. Errors in these instructions can prevent the fetus’s organs from growing and working properly.
The fetus may not get the nutrition it needs to grow at a healthy rate. This is calledintrauterine growth restriction. It’s a common cause of stillbirths.
You’re more likely to experience problems during pregnancy if you have a chronic health condition, like diabetes, lupus, high blood pressure, obesity or a blood clotting disorder.
Still, having a chronic condition doesn’t mean you’ll experience complications. A provider can help you manage chronic conditions and keep tabs on your health to reduce your risk.
Pregnancy complications that may lead to stillbirth include:
Often, the only warning sign of stillbirth is noticing the fetus isn’t as active as it used to be. Some people experience cramps and vaginal bleeding.
These symptoms don’t always mean a stillbirth, but you should see a provider immediately if you notice these changes.
Most stillbirths happen before labor. Your provider will use an ultrasound to find the fetus’s heartbeat.
For some people, learning what caused a stillbirth is important for closure. Understanding the circumstances surrounding a loss can help as you allow yourself to grieve. For others, knowing the cause can reduce the risk of future pregnancy complications.
Your healthcare provider will review your medical records and the circumstances surrounding the loss. They may perform tests on the fetus, the umbilical cord or the placenta to determine the cause.
It’s a difficult decision. Some parents find the thought of an autopsy too much to bear following such a heartbreaking loss. Not all insurance plans cover fetal autopsies, so cost also plays a role.
The greatest benefit of having an autopsy is that it increases the chance of learning what caused the stillbirth. Recent research has shown that an autopsy can increase the detection rate from just under 20% of stillbirths to more than 90%. This information may help your provider prevent complications in future pregnancies.
Still, every case is different, and this is a deeply personal decision. Talk with your provider to decide what’s best.
Your healthcare provider will recommend the safest option available to deliver the fetus. The experience will feel similar to delivering a live baby. Your pregnancy care team will coach you and give you medicines to help with the pain.
You’ll have options about how much interaction you want with the fetus. There’s no right or wrong way to feel or respond.
For example, you can hold the fetus if you’d like. You may ask for mementos and keepsakes, like a lock of hair or their hospital ID bracelet. Most hospitals will issue a birth certificate. You can request that it includes handprints and footprints.
Take as much time as you need, and don’t hesitate to reach out to others for support. Having loved ones nearby can help with processing the loss.
Milk usually starts coming in within a few days after delivery. Unless you have preeclampsia, you can take medicines called dopamine agonists to stop your breasts (chest) from producing milk. Or, you may prefer to let the process stop naturally. Let your provider know what feels right for you.
There’s usually nothing you can do to prevent a stillbirth. Often, it happens because of a medical condition or complication outside of your control. But every pregnant person can take steps to increase the odds of delivering a healthy baby:
Yes. Most people go on to have normal pregnancies and healthy babies. If a congenital disability or umbilical cord problem caused the stillbirth, there’s a slight chance of another. If the cause was an illness or a genetic disorder, the chance that your next pregnancy will result in stillbirth is only about 3%.
Some studies show that people who wait at least one year to conceive after a stillbirth have less depression and anxiety during a later pregnancy. Still, everyone’s on a different timeline when it comes to being physically and emotionally ready to try again.
Discuss the timing of your next pregnancy with your provider.
Take as much time as you need to grieve after a stillbirth. Mourn in ways that feel most healing for you. This may mean having a funeral to grieve alongside friends and family members who want to support you during this time. It may mean asking for help with childcare so you can take time to process your feelings alone.
Counseling and pregnancy loss support groups are also excellent resources. Regardless of the stage of pregnancy, you’re still a parent. The bond you nurtured is real. It’s normal to experience depression and post-traumatic stress disorder (PTSD) that requires professional help to cope with a loss this big.
A note from Cleveland Clinic
A stillbirth is a devastating loss that may take time to grieve. Remember that it’s normal to have difficulty coping. It’s OK to reach out to support groups and mental health professionals to help you through this.
If you’re concerned about the risks of a future stillbirth following a loss, seek counseling from your pregnancy provider or a maternal-fetal medicine (MFM) specialist. They may recommend tests or genetic counseling to assess your risks. The decision to try to get pregnant again is a huge one. There are specialists available to advise and support you.
Last reviewed by a Cleveland Clinic medical professional on 09/06/2023.
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