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Stillbirth


Expert reviewer, Dr Evelyn Ferguson, Consultant Obstetrician and Gynaecologist
Next review due August 2022

Stillbirth is when your baby dies in your womb after 24 or more weeks’ pregnancy. If your baby has died in your womb, you’ll need to give birth. Around one in 200 births in the UK are stillbirths.

Grieving for the loss of a baby is a very personal and difficult experience. You may find it helpful to talk to a counsellor, especially if you’re having difficulty coping. Counselling will be offered to you and to your partner.

Woman sitting on the bed embracing her legs

Stillbirth symptoms

There are some symptoms that might suggest that your baby is at risk of dying in your womb or might have died. These include the following.

  • Your baby is moving significantly less or the pattern has changed.
  • You have an unusual discharge from your vagina. This might be a sign that you have an infection or that your waters have broken early.
  • You have pre-eclampsia symptoms, such as severe headaches, seeing flashing lights, and sudden swelling of your feet, ankles, hands and face or pain below your ribs.
  • You have vaginal bleeding, which may indicate a problem with the placenta.
  • You have severe tummy pain or contractions, which may indicate early labour or a problem with the placenta.

If you have any of these symptoms, contact your labour ward, midwife or GP right away. It may turn out that there’s nothing to worry about, but it’s best to be cautious.

Diagnosis that your baby has died

If your baby has died, you might have noticed the symptoms or it might be discovered in a routine check-up.

If your obstetrician (a doctor who specialises in pregnancy and childbirth) or midwife is concerned about the health of your baby, they’ll check your baby’s heartbeat. This is done with a handheld Doppler device or a cardiotocograph machine. If your baby’s heartbeat can’t be detected, they’ll arrange an ultrasound. If your baby’s heart is not beating on the ultrasound, your obstetrician or midwife will confirm that your baby has died.

If your baby has died, the news will obviously come as a huge shock. Your obstetrician will help you make choices about what happens next. You will need time to think and may well find it difficult to take on board all the information you’re given. Your obstetrician will understand – ask questions and let them know how you’re feeling and what you want to do.

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Causes of stillbirth

For most parents, it’s important to know why their baby died. Unfortunately, a reason can only be found in about half of all stillbirths. Most often, stillbirth is due to the baby not getting the oxygen and nutrients it needs because there is a problem with the placenta. For example, the placenta may come away from the womb wall before birth (this is called placental abruption). There are many other reasons a stillbirth can happen though. These include:

  • pre-eclampsia, which causes high blood pressure and protein in your urine
  • medical conditions such as diabetes, high blood pressure or problems with blood clotting
  • the umbilical cord being trapped or coming out of the cervix (a prolapse)
  • rupture of your womb
  • congenital problems (conditions that happen in the baby before birth)
  • infections carried across the placenta, for example rubella (German measles), measles, herpes simplex and syphilis
  • infections from the vagina, including chlamydia
  • taking illegal drugs

Care during a stillbirth

If your baby has died in your womb, you’ll need to give birth. Your obstetrician will explain the process and your options. You’ll be cared for sensitively by your care team, which can include an obstetrician, midwife, nurse and anaesthetist.

You’ll need to make some important decisions, such as:

  • when, where and how to give birth to your baby
  • what investigations you would like to look into the cause of your baby’s death
  • whether to have a memorial service and funeral for your baby, and registering their death

The choices that people make vary and depend on many factors, such as personal beliefs, health and religion. You may find some decisions harder to make than others. Talking to your partner, family, friends, midwife, obstetrician and other professionals may help.

Care during the birth

Legally, as the mother, you have the final say in choices about labour and birth but you don’t need to make decisions alone. Your care team can help and support you. If it’s available, you may want to ask for a private area away from other mothers and babies. Some hospitals have facilities for your partner or a companion to stay with you too. It is important that you are cared for in a safe environment with a specialist team on hand to look after you. They’ll do their utmost to care for you safely and will be sensitive to your need for privacy.

Unless there’s an immediate risk to your health, the birth does not need to happen right away. If you want to, you can delay the process until you feel more prepared. If you choose to wait for the birth to begin naturally, you’ll usually go into labour within three weeks of your baby’s death. You’ll need to have a blood test twice a week to check your health. It’s best not to delay too long as it can lead to complications. Waiting can also make it harder to work out why your baby died.

Alternatively, you may choose or need to have your labour induced with medicines. You’ll likely be given a tablet to take, which can take up to 48 hours to start working, although most women give birth within 24 hours. You may need to go home while you’re waiting for the medicines to take effect or you may need to stay in hospital. Ask your midwife what you need to do. Once the medicines start to take effect, you’ll need to go to hospital and will start to have contractions. You’ll have options for pain relief throughout.

You’ll usually be advised to give birth naturally (vaginally) rather than have a caesarean (an operation), because there are fewer health risks and you’ll recover sooner. Your care team will make the necessary arrangements and will do their best to make you comfortable and minimise your distress and pain.

Once your baby is born, be prepared that the room may feel quiet. You can see, hold and spend time with your baby after you give birth. You may feel frightened or unsure about seeing your baby. Don’t feel pressured to see them if you don’t want to. Equally, it’s an extremely precious moment for some parents. Do what is right for you.

Your care team can help with mementos of your baby, such as photos, a hand or footprint or lock of hair. It’s your choice whether or not you have these. They can be kept securely at the hospital if you’re unsure.

Care immediately after a stillbirth

After you give birth, you’ll receive any medical treatment and support you need. A community midwife may visit you to offer emotional support and check your physical recovery.

If you need to stay in hospital, there might be an option to stay in a different area from the maternity ward. As soon as you’re well enough, you can go home. Women who have had a stillbirth still produce breast milk, which can be painful both emotionally and physically. You can take medicines to stop your breast milk. You’ll also have vaginal bleeding after the birth for a few weeks or so.

It’s best not to get pregnant again until you feel physically and mentally ready, so your care team may give you advice on contraception. They’ll also let other healthcare professionals involved in your pregnancy and antenatal care know what has happened.

Complications of stillbirth

Your obstetrician may recommend that you give birth where emergency care is available, so you can receive urgent care if you need it.

Problems that can occur after a stillbirth include:

  • infections
  • haemorrhage (severe bleeding)
  • pre-eclampsia

If there’s a delay between your baby dying and you giving birth, there’s a greater risk of you developing blood clotting problems. If your blood’s clotting system becomes imbalanced, it can lead to blood clots forming or bleeding. If this happens, a haematologist (a doctor who specialises in blood disorders) will discuss heparin treatment to reduce your risk of blood clots.

Making arrangements after the birth

If you’d like to name your baby, do this before you register the death because the name can’t be changed or entered afterwards.

Your care team can provide information to help you make plans for a burial or cremation and remembrance for your baby. If you want to hold the funeral within 24 or 48 hours of your baby’s death for religious reasons, let them know right away. If your baby is having a post-mortem, arrangements will need to be made swiftly. It may be that a full post-mortem can’t be performed in the timeframe.

Investigations into the cause

Your obstetrician will recommend that tests are done to check your health and to try to work out why your baby died. These tests can help to see if you’re at risk of having another stillbirth, and how you may be able to reduce this risk.

Assessments that you’ll be offered include:

  • a physical examination
  • blood tests to check for a range of conditions including diabetes, clotting problems and infections such as parvovirus
  • urine tests
  • vaginal and cervical swabs
  • an examination of the placenta

You will be asked to sign a consent form for some of these tests. You can also choose whether or not to give your permission for genetic testing and a post-mortem (autopsy) of your baby. These tests often help to confirm why your baby died but you don’t have to give your consent for these if you don’t want to. For more information on what happens in a post-mortem, see our FAQ: What happens during a post-mortem?

Follow-up care

You’ll be offered a follow-up appointment about six to eight weeks after the birth. This is to check how you’re doing, to talk through any results the hospital has so far, and to answer your questions. This will usually be at the hospital, but depending on your local services, you may be able to have it elsewhere, possibly at home.

If your baby had a post-mortem, you’ll be invited to an appointment with an obstetrician after six to 12 weeks to discuss the results.

Coping with your emotions

Losing a baby is a devastating event. You and your partner are likely to have a range of emotions, which may include fright, shock, profound grief and sadness. Some people feel numb, confused, angry or guilty. Your emotions may come in waves, and sometimes be hard to control or be unpredictable. In addition to these emotions, you might develop postnatal depression – treatments are available to help.

Trying to cope with the loss of a baby can also put a strain on your relationships with loved ones. Family members are likely to be strongly affected too and want to do all they can to support you. You may find it important that others recognise and accept your grief.

You and your family will be offered counselling. There’ll be support groups to help you too, and you may have a bereavement officer assigned to help co-ordinate the support you need. For spiritual guidance, your maternity unit can arrange for you to see an elder from a common faith or an adviser from a non-religious organisation.

Some parents find that they begin to feel more able to cope and their life returning after a few months, although their baby isn’t forgotten. For others, strong emotions or depression can continue or they can develop post-traumatic stress disorder. Be sure to ask for any help you need, especially if you’re struggling with day-to-day life around six months later. Your hospital or GP can refer you for specialist help and support.

Preventing stillbirth

Investigations into the cause of your baby’s death may help to find out how to prevent having another stillbirth. So it’s best to wait for the results before trying for another baby.

It’s natural to be very anxious about stillbirth happening again. Depending on the reason for your baby’s death, you may be more at risk of it happening again, but this isn’t always the case. Your doctor will explain your risk to you.

If investigations find that you have an underlying health condition, you may need additional treatment and check-ups if you become pregnant again. And whether a cause is found or not, you’ll usually have antenatal care with an obstetrician and give birth in a specialist maternity unit.

If your baby was found to have a genetic disorder, your doctor may refer you to a genetics specialist for support and counselling. If you get pregnant in the future, you might be able to have tests to check for the condition. You might also be able to have a type of in vitro fertilisation (IVF) called preimplantation genetic diagnosis to select an embryo without the condition.

Some things can increase the chances of stillbirth. It’s more likely if:

  • you’re over 35
  • you’re expecting twins or triplets
  • you’re obese or smoke – losing weight and keeping a healthy weight can reduce your risk, as can stopping smoking

You can take steps to reduce your risk of getting infections. For example, you might want to have the MMR vaccine to protect against rubella (German measles).

Frequently asked questions

  • It’s often possible to tell whether your baby is a girl or boy right away. But if your baby died a while ago, their appearance may have changed, which can make it hard to be sure of their sex. A specialist or a post-mortem will be able to confirm your baby’s sex. Genetic tests can provide an answer too. If tests can be done straight away, you should have an answer within two working days.

    Sometimes, the results of tests might not be back before you wish to register the birth. You can make a judgement yourself about your baby’s sex or ask your care team to do this. Some parents choose to use a nickname or name that can work for both sexes.

  • A post-mortem is carried out by a perinatal pathologist who will treat your baby’s body with dignity and care at all times. Your baby may need to be transported to another location for the post-mortem but will be returned afterwards.

    In a complete post-mortem, the pathologist will:

    • weigh and measure your baby
    • examine the outside of their body
    • examine the placenta, umbilical cord and membranes
    • open the body to measure, weigh and examine each of your baby’s internal organs
    • take samples of body fluid, such as blood or urine, to be tested
    • take small samples of tissue to examine
    • arrange for genetic testing of some tissue samples
    • store some samples that could be tested in the future, if needed
    • take an X-ray of your baby’s skeleton and possibly, other photographs or images

    You won’t be able to see any marks from the procedure when your baby is wearing clothes or wrapped in a blanket.

    If there are parts of the post-mortem you don’t want your baby to have, discuss this with your care team. If you wish, you can give your consent for some but not all procedures to be done. You can also choose for your baby to be examined on the outside of their body only.

    Rarely, a coroner (or procurator fiscal in Scotland) may order a post-mortem by law.


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  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, August 2019
    Expert reviewer, Dr Evelyn Ferguson, Consultant Obstetrician and Gynaecologist
    Next review due August 2022



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