Why do stillbirths happen, and what are the signs to watch for? We’ve broken down everything you need to know about this devastating pregnancy loss.

By Dr. Laura Riley and Nicole Harris
Updated February 25, 2020

A baby who dies in utero after 20 weeks of pregnancy—or one who dies during delivery—is considered stillborn. Any family death is devastating, but a stillborn baby can be especially tragic because it often happens suddenly and without warning. Thankfully, though, having a stillborn baby is extremely rare. Read on to learn more about the causes and signs of stillbirth. 

How Common is Stillbirth?

Only 1 percent of pregnancies end in stillbirths, according to the Center for Disease Control and Prevention (CDC). That means about 24,000 babies are stillborn each year in America. The rate of stillbirths has actually decreased in the past few decades, though, thanks to advanced fetal care and medical technology. More than 50% of stillbirths happen before the 28th week of pregnancy. 

What Causes Stillbirth? 

There are many complex reasons why a baby might be stillborn, including infection, genetic abnormalities, and problems with the placenta (for example, placental abruption or another condition that restrict the fetus’s nutrients and oxygen supply). Less common causes include delivery trauma, maternal high blood pressure or diabetes, and umbilical cord accidents. One-third of the time, however, there appears to be no explanation at all, even after the baby is delivered and examined. 

Risk Factors for Stillbirth

While stillbirth can happen to anyone, researchers have determined a few risk factors that slightly increase your odds. According to the CDC, stillbirth risk factors include:

  • Having a previous stillbirth—although your odds of a subsequent stillbirth are still less than 1 percent, according to March of Dimes
  • Being obese
  • Drinking or smoking during pregnancy
  • Suffering from high blood pressure, diabetes, and other medical problems 
  • Being of black race
  • Being under age 20 or over age 35 
  • Having low socioeconomic status
  • Expecting multiples (twins, triplets, quadruplets, etc.)

Keep in mind that more research needs to be done on exactly why these factors lead to higher rates of stillbirth.

Signs of Stillbirth

Some women learn about their stillbirth after their baby stops moving and kicking. Their uterus might feel still and heavy without the usual movements of the baby. Other stillbirth symptoms include vaginal bleeding, cramping, or pain. "But there often are no physical symptoms to alert you to a potential stillbirth," says Bruce Flamm, M.D., a Parents advisory-board member and a clinical professor of obstetrics and gynecology at the University of California, Irvine. "You should be aware of your unborn baby's movement, but not consumed by it." 

If you notice any significant decrease in your baby's activity—fewer than 10 movements in 2 hours—-contact your provider immediately, says Laura Riley, M.D., an OB-GYN in New York City. He will check for your baby's heartbeat with an ultrasound. If it’s not too late, you may need a medical intervention to save your baby's life. 

Delivery After Stillbirth

If your baby dies, you will probably start laboring naturally within a couple of weeks. Many women, however, are too upset to continue the pregnancy, and your provider may suggest inducing your labor within hours or days. A vaginal delivery is still preferable to a cesarean, which poses more health risks.

During the labor and delivery, you may ask for pain medicines or an epidural when you need it, says Dr. Riley. Don't be afraid to ask for information from your nurses, your provider, and whoever examines your baby and placenta following the birth. Although very difficult to think about at the time, autopsy and examination of the placenta may yield important data. 

Dealing with a Stillbirth

There is no single way to accept this dreadful loss. You and your partner will want support from friends and family, and it may help to join a bereavement group or see a therapist. A memorial or funeral service will help you and your family to grieve; read more about stillborn baby funerals here. Consider keeping a journal and a few mementos of this life you carried—a footprint, a lock of hair, a photograph—and don't be afraid to look at them from time to time. This baby was a part of you and a part of your family, however briefly, and deserves to be remembered.

Miscarriage vs. Stillbirth Definition

Although they both deal with pregnancy loss, stillbirth and miscarriage are different phenomenons. In America, stillbirth is the death of a baby after 20 weeks gestation. Miscarriage is pregnancy loss before 20 weeks. 

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