Stillbirth - What Expectant Parents Need To Know

For most parents to be, planning the arrival of a baby is a time filled with happiness and anticipation.

Yet for six parents every day in Australia, their lives are turned upside down due to stillbirth.

Worldwide, it’s estimated that millions of babies are stillborn each year, with 99% of those in developing countries.

What is rarely reported in the media, is that stillbirth is nearly 10 times more common than Sudden Infant Death Syndrome.

Why is it that stillbirth, which affects so many parents, is not being given the attention it deserves?

Some health professionals can be unwilling to discuss the possibility of a baby dying before birth with women who are experiencing a healthy, low-risk pregnancy. While around one-third of stillbirths are unexplained, there are some known risk factors for stillbirth, for example, maternal or passive smoking and maternal obesity. Increased awareness of these things may help to prevent some stillbirths from occurring.

There is also a lack of research into the causes of babies dying in utero. More research would help health professionals have a greater understanding of how to prevent stillbirth.

A current study at the University of Melbourne is looking at placenta function early on in pregnancy through blood testing. If this test is successfully developed, it could predict early enough which babies are at risk of being stillborn. But much more research is needed to understand exactly what factors put babies at risk.

Stillbirth – Important Things To Know

For those who have been given the devastating news that their baby has died in utero, there are many things to consider and come to terms with. Supporting family and friends can feel shocked and disbelief, not knowing what to do or how to help.

Here are five vitally important things to know about stillbirth that will help everyone affected by this loss to know:

#1: Labour and Birth

Most stillbirths happen before labour begins. An ultrasound may have discovered there is no heartbeat and a decision needs to be made as to how the birth will occur. Vaginal birth is preferred for a number of reasons, not least the personal wishes of the mother, who may feel strongly that she wishes to birth her baby normally. Cesarean section has a greater possibility of post-surgery infection and other associated risks and takes much longer to recover from physically.

Unless there is an urgent medical reason for the birth to happen immediately, mothers may be able to wait for labour to begin naturally, or have some time to take in what has happened and prepare for induction. Hospital staff will discuss induction options and the availability of pain relief if needed. There will also be support during labour and afterward from experienced midwives and doctors. Parents will be given an opportunity to think about and decide beforehand what will happen after birth.

#2: After The Birth

The range of very intense emotions is overwhelming, for both mother and her partner, particularly being afraid to see their baby for the first time. Once a baby is born, parents have the choice of holding their baby straight away or having the baby wrapped and passed to them. This can be an intensely emotional time and there is no ‘right’ way to deal with it.

Parents are supported and encouraged to spend as much time as they wish with their baby. Midwives may suggest parents bathe their baby, dress them in any special clothing, and create special memories with photographs and hand/feet printing. There is no rush and parents will be able to invite family to come and meet their baby.

This can be a really important step for both parents and their supporting family and friends, as it provides them with the chance to grieve and to perform any special religious or cultural rituals. In the future, this shared experience will be a foundation of support for the parents who must go on without their baby.

#3: Investigating The Cause

It is normal for parents to want to know why stillbirth has happened and if it is likely to occur in the future.

After the birth, the cord and placenta are examined carefully to see if there is any indication of what has caused the stillbirth. While testing does not always provide answers, parents may be asked if these tissues can be further evaluated in the lab. This can be a difficult decision to make while grieving but it has the potential to determine if there was a genetic or known reason why the stillbirth occurred.

Other tests such as tissue sampling, ultrasounds, and MRI may also be used. An autopsy is a big decision for grieving parents to make and they may have a lot of fear about what happens to their baby during the process. Health care providers can answer any questions and allow parents to make the decision that they feel most comfortable with.

#4: Birth Registration, Certificate, and Funeral

In Australia, the definition of stillbirth is a baby who has died in utero after 20 weeks of gestation or weighs 400 grams. The birth of a stillborn baby is required to be registered and parents will be given a form at the hospital which they will need to fill and return, usually within 60 days. Parents can apply to their State’s Birth, Deaths and Marriages registry for a birth certificate.

The thought of planning a funeral for a baby can be overwhelming. It is a legal requirement to hold a funeral for stillborn babies and there are many services available to help parents with this. The hospital chaplain can arrange a service, or parents may prefer to choose a private funeral home.

#5: Grief and Support

The intense emotions that parents go through after hearing the news their baby has died can be overwhelming. Dreams and wishes for a life that won’t be fulfilled are shattered and parents may feel despair at getting on with life after such a devastating experience. Support is available from a number of dedicated organisations, as well as grief counselors and social services through hospitals.

Many family members and friends avoid discussing stillbirth in the misunderstanding that it will be painful, but for most parents of stillborn children, the opposite is true. Not being able to talk about their baby can contribute to further grief and feelings of despair. Providing parents with the ability to openly grieve for and talk about their baby can be a big part of the healing process.

We use the term ‘unthinkable’ when referring to the death of a baby and it is one of the hardest things to contemplate let alone live through. My personal experience of losing a baby at almost 20 weeks led me to talk more openly about what I had been through and to connect with those who were holding their own losses in their hearts. In bringing forward the name and existence of my baby, it highlights to others that their loss should be acknowledged. The more we are able to face the future with understanding and support, the more we can bring stillbirth out of the shadows and offer more hope and support for others.

Giving Birth After Stillbirth

Parents who have experienced a previous stillbirth may find subsequent pregnancies and birth a harrowing and nervous experience. BellyBelly has a fantastic article, Giving Birth After Stillbirth, which is a fantastic, touching read.

Resources and Support

The following links provide information, resources and support for parents of stillborn babies. Family and friends can also access information about how to support parents.