Stillbirth: Causes, Symptoms, Types, and Prevention Strategies

Introduction

Losing a baby to stillbirth is one of the toughest experiences for a parent. Surrounded by many challenges and profound emotions. Learning about stillbirth can be an important step in the healing process. This article aims to provide clear information about stillbirth, including its causes, symptoms, types, and prevention methods.

What is Stillbirth?

Stillbirth is when a foetus dies after the 20th week of pregnancy. Some people think it only happens during delivery when the foetus is born without a heartbeat during labor. However, most of the stillbirths occurs inside the womb and are usually found out before labor starts. Losing a baby this way can be very painful, similar to a miscarriage. However, it's crucial to understand that stillborn vs miscarriage distinguishes between two different types of pregnancy loss. Miscarriage refers to fetal death before 20th week of pregnancy while stillbirth happens post-20 weeks.

What are the types of Stillbirth?

Medical professionals classify stillbirths based on gestational age at which fetal death occurs:

1. Early stillbirth: Fetal dies between 20 and 27 weeks
2. Late stillbirth: Fetal dies between 28 and 36 weeks
3. Term stillbirth: Fetal dies after the 37th week

Each type presents its unique challenges for parents to navigate through.

How Common are Stillbirths?

Stillbirth rates vary worldwide. In developing countries, about 22 out of every 1,000 births result in stillbirth. In contrast, in developed countries like the U.S. and U.K., the rates are much lower, around six and three per 1,000 births respectively. Improved prenatal care has significantly reduced global stillbirth rates, although disparities persist due to varying access to healthcare services.

Who Is at Risk for Stillbirth?

While stillbirth can occur during any pregnancy, certain factors amplify the associated risks:

• Age: The risk is higher for teenagers and those 35 or older.
• Certain Health Conditions: Existing health issues such as high blood pressure, diabetes, thyroid disorders, obesity, etc., may increase the risk.
• Type of Pregnancy: Multiple pregnancies (twins or more) pose an increased risk.
• Past Pregnancy Complications: Having experienced a previous stillbirth or other complications like preterm birth slightly raises the risk.
• Stress and Substance Use: Use of recreational drugs, smoking, drinking alcohol can lead to stillbirth. Similarly, significant life stressors like financial strain or relationship problems can also increase your risk.

What Causes Stillbirth?

The causes of stillbirth can be complex.

They may include:

1. Infections: Infections from viruses, bacteria, or parasites can lead to stillbirth, particularly in areas with limited access to quality prenatal care.
2. Problems with the Placenta or Umbilical Cord: The placenta and umbilical cord supply the foetus with oxygen and nutrients. Problems here can prevent the foetus from thriving.
3. Genetic Conditions Affecting the Foetus: Genetic conditions or birth defects that affect foetal development can result in stillbirth. One such condition is intrauterine growth restriction where the foetus doesn’t get enough nutrition to grow healthily.
4. Pregnancy Complications: Complications like preeclampsia (high blood pressure during pregnancy), cholestasis of pregnancy (liver disease), and premature birth can lead to stillbirth.

What are the Symptoms of Stillbirth?

The main symptom of stillbirth is a noticeable reduction in fetal activity. Some women may also experience cramping or vaginal bleeding. If you notice these symptoms, it's crucial to seek immediate medical attention.

How is the Diagnosis Made?

Most stillbirth diagnoses occur before labor when healthcare providers cannot find a fetal heartbeat through an ultrasound.

When Should I Choose to Have a Foetal Autopsy?

Consider a fetal autopsy for unexplained deaths, genetic concerns, or recurrent losses. It’s a personal decision that can provide important information for future pregnancies. Always consult your healthcare provider.

What Happens After the Foetus Passes Away?

Grieving the loss of a baby takes time. Some parents may wish to hold their baby, keep mementos, or even have a funeral. Support from loved ones and professional counselling can be beneficial during this time.

Can Stillbirth Be Prevented?

Although you cannot prevent all stillbirths as some result from uncontrollable factors, steps such as avoiding recreational drugs and alcohol, maintaining a healthy weight before pregnancy, adjusting diet during pregnancy, infection prevention measures, getting routine tests, ultrasounds and/or foetal heart monitoring can help increase the odds of delivering a healthy baby.

Can I Get Pregnant After a Stillbirth?

Yes, it's possible to have a healthy pregnancy after a stillbirth. It's important to work closely with your healthcare provider for advice.

How Can I Take Care of Myself After a Stillbirth?

Discussing the timing of next pregnancy with your healthcare provider is crucial. Some studies suggest that waiting at least one year post-stillbirth before conceiving again can help reduce feelings of depression and anxiety during future pregnancies.

What Tests do You Get After a Stillbirth?

After a stillbirth, clinicians may recommend several tests for both the mother and baby to better understand the situation, including:

1. Autopsy: A thorough examination of the baby's body for defects, requiring parental consent.
2. Imaging: X-rays, ultrasounds, or MRIs to investigate potential causes.
3. Placenta and Umbilical Cord Examination: Microscopic analysis of the placenta and umbilical cord.
4. Genetic Testing: Screening for genetic disorders that may have affected the baby.
5. Amniocentesis: A procedure to extract amniotic fluid if infections or genetic issues are suspected.
6. Blood Samples: Tests on the mother to assess her health.
7. Pregnancy History: A comprehensive review to identify any risk factors.

Clinicians provide information and emotional support, empowering families to decide on the recommended tests as they navigate their profound grief.

Will I Lactate After a Stillbirth?

Yes, lactation is possible after a stillbirth. Typically, your body requires 2-3 weeks to cease milk production, and leakage may continue afterward. If you choose to express milk, production can persist until you decide to stop. This is a normal response from your body.

What Happens After Delivery?

After delivery, your body experiences many changes, both physical and emotional, some of which can last for months. You may feel tired, have mood swings, or experience physical discomfort. It’s important to prioritize rest and eat nutritious foods to aid your recovery. Many women experience a mix of feelings and symptoms during this time, which is completely normal. Be kind to yourself as you adjust, and don’t hesitate to seek support from friends, family, or professionals. Caring for yourself is important for both your health and for connecting with your baby.

How Long After A Stillbirth Should I Get Pregnant Again?

After experiencing a stillbirth, it's often recommended to wait at least a year before trying to conceive again, as studies indicate this may help reduce depression and anxiety in subsequent pregnancies. However, everyone’s healing journey is unique. It's vital to discuss your individual circumstances and readiness with your healthcare provider.

Conclusion

Understanding stillbirth, including its causes, risk factors, and coping mechanisms, is an important part of healing after such a deep loss. It’s essential to talk to healthcare providers for personalised advice and support. At Metropolis Healthcare, we focus on accurate diagnostic services to assist you. Our patient-centered approach ensures you receive reliable health check-ups at your convenience, with at-home sample collection by qualified technicians. Taking care of your health is possible with the right knowledge and medical support.