Stillbirth

Causes of stillbirth

Some stillbirths are linked to complications with:

• the placenta
• a birth defect
• the mother's health

For others, no cause is found. Many stillbirths happen in healthy babies and the reason often can't be explained.

Complications with the placenta

Many stillbirths are linked to complications with the placenta.

The placenta is the organ that links the baby's blood supply to the mother's and nourishes the baby in the womb.

If there have been problems with the placenta, stillborn babies are usually born perfectly formed, although often small.

Other causes of stillbirth

Other conditions that can cause or may be associated with stillbirth include:

• bleeding (haemorrhage) before or during labour
• placental abruption – where the placenta separates from the womb before the baby is born (there may be bleeding or abdominal pain)
• pre-eclampsia – a condition that causes high blood pressure in the mother
• a problem with the umbilical cord, which attaches the placenta to the baby's tummy button
• intrahepatic cholestasis of pregnancy (ICP) or obstetric cholestasis– a liver disorder associated with severe itching during pregnancy
• a genetic physical defect in the baby
• pre-existing diabetes
• an infection in the mother that also affects the baby

Increased risk of stillbirth

There are a number of things that may increase your risk of having a stillborn baby, including:

• having twins or a multiple pregnancy
• having a baby who doesn't grow as they should in the womb
• being over 35 years of age
• smoking, drinking alcohol or misusing drugs while pregnant
• being obese – having a body mass index above 30
• having a pre-existing physical health condition, such as epilepsy

Your baby's growth and movements

Your midwife will check the growth and wellbeing of your baby at each antenatal appointment and plot the baby's growth on a chart.

Every baby is different and should grow to the size that's normal for them. Some babies are naturally small, but all babies should continue to grow steadily throughout pregnancy.

If a baby is smaller than expected or their growth pattern tails off as the pregnancy continues, it may be because the placenta isn't working properly. This increases the risk of stillbirth.

Problems with a baby's growth should be picked up during antenatal appointments.

It's important to be aware of your baby's movements and know what's normal for your baby.

Tell your midwife immediately if you notice the baby's movements slowing down or stopping.

Don't wait until the next day.

What happens when a baby dies before they're born

If your baby has died, you may be able to wait for labour to start naturally or your labour may be induced.

If your health is at risk, the baby may need to be delivered as soon as possible.

It's rare for a stillborn baby to be delivered by caesarean section.

After a stillbirth

After a stillbirth, decisions about what to do are very personal. There's no right or wrong way to respond.

A specialist midwife will talk with you about what you want to do, for example, holding the baby or taking photographs. They can also discuss the tests you may be offered to find out why your baby died and give you information about registering the birth.

 Further information about still-birth and baby-loss support groups is available at:

• What happens if your unborn baby dies

Reducing the risk of stillbirths

Not all stillbirths can be prevented, but there are some things you can do to reduce your risk, such as:

• not smoking
• avoiding alcohol and drugs during pregnancy – these can seriously affect your baby's development and increase the risk of miscarriage and stillbirth
• not going to sleep on your back after 28 weeks – don't worry if you wake up on your back, just turn onto your side before you go back to sleep
• attending all your antenatal appointments so that midwives can monitor the growth and wellbeing of your baby

More useful links

• Stillbirth
• How to use your health services
• Pregnancy and trying for a baby