Stillbirth : Types, Symptoms, Causes, Treatment and Risk Factors

Overview 

When women lose their baby between the 20th week of pregnancy and birth, it is known as a stillbirth. If they lose the baby before the 20th week, it is typically known as a miscarriage. Stillbirths can be distressing for parents since many of them occur in normal pregnancies. The causes are unknown for about a third of the cases. Placenta or umbilical cord problems, infections, high blood pressure, congenital disabilities, or a poor lifestyle can cause stillbirths. Most women who suffer a stillbirth can have a healthy baby in their subsequent pregnancy. 

This blog explains stillbirth, its causes, symptoms, complications, risk factors, treatment and prevention in detail.

What is a stillbirth?

A stillbirth is when a baby dies after the 20th week of pregnancy. The baby could have passed away in the uterus weeks or hours before delivery. The baby rarely dies during delivery. Stillbirths can still occur even with improvements in prenatal care over the years. With an ultrasound, the doctor can determine the baby’s heartbeat in the womb. If they do not notice any heartbeat and decide the baby has died, they can use many methods for delivery, including inducing labour.

What are the types of stillbirth?

Doctors categorise a stillbirth into three types. They are an early stillbirth, a late stillbirth, or a term stillbirth. The doctors determine the type by counting the duration of the pregnancy:

• Early stillbirth -occurs if the fetus passes away between 20 and 27 weeks of the pregnancy.
• Late stillbirth – occurs if the fetus passes away between 28 and 36 weeks of the pregnancy.
• Term stillbirth – occurs if the fetus passes away in the 37th week of pregnancy or after.

What are the symptoms of a stillbirth?

A stillbirth typically has no warning signs. However, the following symptoms could suggest a problem.

• Vaginal bleeding, particularly in the second half of pregnancy, can indicate a problem with the baby. If women suffer bleeding, they must consult the doctor immediately. However, many women who suffer vaginal bleeding in their pregnancy go on to have a successful pregnancy.
• Lack of movement or an alteration in the baby’s regular activity.

When should women consult a doctor?

Women must consult a doctor when they have the above symptoms.

Request an appointment at Apollo Hospitals

What are the causes of stillbirth?

Doctors must know the cause of the stillbirth to help the parents with the grieving process. The causes of about a third of stillbirth cases are not always known. However, the probable causes include the following:

• Pregnancy and labour complications nearly cause one-third of stillbirths. It can include preterm labour, twin pregnancy or triplets, and separation of the placenta, which supplies nutrients and oxygen to the baby from the womb. 
• Placental problems, including a lack of blood flow to the placenta, occur in about one-fourth of stillbirth cases.
• Developmental abnormalities – genetic or structural disorders in the fetus can cause more than one in ten stillbirth cases.
• Infection – an infection in the fetus, the placenta, or pregnant woman can cause stillbirths. It is noticed in more than one in ten stillbirth cases.
• Umbilical cord problems can cause about 1 in 10 stillbirths. For instance, the cord can become tangled, cutting off the oxygen supply to the fetus.
• High blood pressure – some types of hypertension may contribute to stillbirths. It can include chronic high blood pressure and preeclampsia, a condition involving high blood pressure linked to pregnancy.
• Medical conditions in pregnant women – conditions such as diabetes, heart disease, thyroid disease, or viral/bacterial infection may cause stillbirths.
• Lupus– pregnant women with lupus are at risk of having a stillbirth.
• Clotting disorders – pregnant women with blood clotting disorders such as haemophilia are at significant risk for stillbirth.
• Lifestyle choices such as drinking alcohol, use of recreational drugs and smoking
• Trauma such as a car crash may cause stillbirth.

What are the risk factors for a stillbirth?

The following risk factors can increase women’s chances of stillbirth:

• Smoking
• A previous stillbirth
• Obesity
• Alcohol or drug abuse
• Women with multiple births (twins or more)
• Women under the age of 15 or over the age of 35
• Poor prenatal care.
• Malnourished women
• Preexisting health conditions.
• Obesity (body mass index above 30).

How is a stillbirth treated?

Doctors typically have many options for delivering the baby if it dies before delivery. In several cases, the doctors need not use these options immediately unless the women suffer medical complications. 

The doctor typically waits for the woman to deliver. In most stillbirth cases, women can deliver babies vaginally after labour induction unless specific health issues necessitate cesarean delivery.

In stillbirth cases, women can ask for special arrangements before they deliver the baby. It can include a private room or a room away from other pregnant women delivering babies. Women can see the baby, give it a name etc . As with other deliveries, women can experience breast engorgement, depression, discomfort from an episiotomy, and other issues after a stillbirth. The combination of recovering physically and emotionally may seem overwhelming.

A stillbirth can be emotionally distressing. A qualified counsellor, psychiatrist or psychologist can assist women and their families in overcoming these difficult times. Women can feel guilty. They must remember they are rarely responsible for stillbirths. They usually are in deep grief, anger, and confusion. The baby’s death can also affect marriages. A mental health professional or group support can offer women great support in overcoming these difficult times.

Can women prevent a stillbirth?

Women cannot prevent a stillbirth since many factors are out of control. However, they must take the following steps to reduce the risk:

• Get a checkup before they become pregnant again. If they suffer from any risk factors, such as diabetes or high blood pressure, they can consult with the doctor to manage and monitor them when they are pregnant.
• Get regular  prenatal care.
• Avoid smoking or using alcohol, marijuana, or other drugs during pregnancy.
• Protect themselves from infections.
• If genetic factors  caused the previous stillbirth, meet a genetic counsellor before becoming pregnant again.
• Get medical help immediately when they experience bleeding or other troubling signs during pregnancy.
• Report any  vaginal bleeding and pain immediately to the doctor.
• Sleep on their side and not the back. When women are pregnant for 28 weeks or more, sleeping on the back can increase the stillbirth risk. 

Doctors monitor women frequently if their pregnancy is high risk. Doctors can take emergency measures when the baby shows signs of distress, including early delivery since it can save the baby’s life.

Conclusion

If a baby dies before or during delivery, it is a stillbirth. Doctors generally detect a stillbirth when the baby’s heart stops beating , through an ultrasound scan. Women with a stillbirth are at a greater risk of having another one. Despite this, women can become pregnant following a stillbirth and go on to have a healthy baby. Women who have a stillbirth should  access resources for mental health support because it is a traumatic event.

Frequently Asked Questions (FAQs)

1. What happens after a stillborn baby dies?

When the baby dies before delivery, they have three options. They include induced labour, natural birth, and cesarean section.

2. How long does the recovery take?

Physical recovery depends on many factors. However, it typically takes around six to eight weeks. Placenta delivery activates women’s milk-producing hormones. They can produce milk for seven to ten days before it stops, and can be given medications to reduce the milk production .

3. Does stillbirth lead to infertility?

A stillbirth does not result in infertility. 

4. When should women consult a doctor after natural birth or induced labour?

Women may have a follow-up appointment with their doctor a few weeks after the stillbirth.