Having a stillborn baby is an extremely distressing situation for a mother and her family.
Many pregnant couples hold the concern of stillbirth as a possibility in the back of their minds.
A baby that has died from 20 weeks up to the due date in pregnancy is called a stillbirth.
It’s more common for babies to have died sometime during pregnancy.
It’s less common for babies to die at the time of birth.
Worldwide, it’s estimated 3.2 million stillbirths occur every year, with the vast majority occurring in developing countries.
In developed countries such as Australia, the UK, and the US, stillbirth rates are relatively low.
The rate of stillbirths in Australia has decreased from 3.6 per 1,000 births in 1999, to 2.4 per 1,000 births in 2018.
To put that into perspective, a stillbirth happened in 0.9% of births in 2018.
This means stillbirth did not happen in 99.1% of births.
According to the US Centre for Disease Control and Prevention, stillbirth affects about 1 in 160 births in the US. Each year about 24,000 babies are stillborn in the United States.
In the UK in 2018, 1 in every 250 pregnancies ended in a stillbirth.
Although we need to stay vigilant for the signs of problems that can lead to stillbirth, it’s reassuring to remember that the vast majority of births aren’t stillbirths.
Given these statistics, the chances of having a stillbirth are very low.
What are the main causes of stillbirth?
In addition to risk factors that can increase the likelihood of stillbirth, there are also factors that can cause or contribute to stillbirth.
In many cases of stillbirth, the cause of death is unknown, despite extensive testing.
Here are 9 of the main causes of stillbirth:
#1: Pregnancy and labor complications
These complications include those in preterm labor and in a pregnancy with twins sharing the same placenta.
Depending on their gestation and size, preterm babies might not be ready to be born, and this increases the chances of preterm babies being stillborn.
Twins that share the same placenta often have uncoordinated growth, as one twin might not get its share of the placenta. This could mean that this twin is at a higher risk of being stillborn.
You can read more about preterm labor in Premature Labor – Signs, Symptoms, and Management.
You can also find some interesting facts about twins in Pregnant With Twins? 8 Interesting Facts About Twins.
#2: Problems with the placenta
Placental abruption occurs when the placenta detaches from the inner wall of the womb (uterus) before birth.
The placental abruption can deprive the baby of oxygen and nutrients and is a medical emergency.
Depending on the degree of placental abruption and how close the baby is to 37 weeks, treatment might include a c-section.
Read more on placental problems in Placental Abruption – 13 Facts You Need To Know.
#3: Birth defects
Birth defects are also called congenital anomalies. They include health or physical abnormalities that range from mild to severe.
Some defects are life-threatening and lead to a baby not developing or dying during pregnancy.
Some birth defects are caused by genes, passed from parents to their baby. Others happen as a result of chromosomal abnormalities. Birth defects can also be caused by exposure to certain chemicals, medications, or infections.
Many people assume stillbirth occurs as the result of a genetic defect; in fact, this is only the cause in around 15-25% of cases.
Infection can lead to stillbirth in pregnancy by directly infecting the baby, causing damage to the placenta, or causing the mother to become very ill.
Around 1 in 10 stillbirths happen due to infection in the mother.
Here is a list of infections that have been linked to an increased risk of stillbirth:
- Group B streptococcus
- Cytomegalovirus (member of the herpes family)
- Maternal infection with rubella, in the first trimester
- Mycoplasma bacteria
- Herpes simplex
- Haemophilus influenza
#5: Problems with the umbilical cord
The Stillbirth Collaborative Research Network reports umbilical cord accidents to account for around 10% of stillbirths.
There are three main types of cord-related accidents:
#1: Nuchal cord: This is when the baby has the cord wrapped around the neck. It can occur during pregnancy, labor, or birth. The umbilical cord is your baby’s blood supply lifeline. While it’s common to have a cord around the neck (or even the baby’s body) if it’s very tight for a long period, it can result in stillbirth.
For more information, please read Nuchal Cord – 9 Facts About A Cord Around Baby’s Neck.
#2: Cord prolapse: This happens when an unborn baby’s cord slips through the cervix and into the vagina, after the amniotic sac breaks, and before the baby descends into the birth canal. The prolapsed cord can become compressed by the baby’s body and cut off the baby’s oxygen supply.
#3: True cord knot: Although this is very rare, a true knot is a tight knot in the umbilical cord, which compresses the blood vessels and reduces oxygen supply, leading to fetal death.
#6: High blood pressure
High blood pressure or hypertension is usually monitored during pregnancy.
It can be a sign of complications such as preeclampsia. This condition affects the arteries that carry blood to the placenta, in turn reducing the amount of oxygen and nutrients the baby needs to survive.
Pregnant women who have high blood pressure and who develop preeclampsia are at a greater risk of stillbirth.
Women who go on to develop HELLP Syndrome are also at greater risk of their babies being stillborn.
#7: Medical conditions in the mother
These health conditions can cause serious harm and lead to a stillbirth if left untreated:
- Obstetric cholestasis: a liver disorder that occurs in late pregnancy. The link between cholestasis and stillbirth isn’t clear, but the disorder is thought to cause irregular heartbeats in unborn babies
- Gestational diabetes: Women with GDM (Gestational diabetes mellitus) are more likely to experience a stillbirth after 35 weeks than those without GDM
- Factor V Leiden: This is a clotting disorder, causing blood clots to form in the placenta. It also increases the risk of developing early-onset gestational hypertension and HELLP syndrome
- Lupus: a chronic autoimmune disorder causing body inflammation. Stillbirths can occur in approximately one-fifth of lupus pregnancies
- Malaria: This disease, transmitted by mosquitos, increases the risk of stillbirth.
#8: Lifestyle choices
Certain lifestyle choices, such as drinking alcohol, smoking, and using recreational drugs, will increase your chances of having a stillbirth.
Poor diet also has an impact on the risk of stillbirth. Nutrition affects your health and that of your baby. Having a high body mass index before becoming pregnant also increases your risk of stillbirth.
#9: Unknown reasons for stillbirth
One-third of stillbirths occur in babies that seem otherwise healthy, and the cause is often unknown.
A post mortem can sometimes provide an explanation for why babies are stillborn, but not always.
How can I prevent stillbirth?
Prenatal care is an important part of reducing your risk of stillbirth. Your care provider can discuss appropriate screening and tests for you.
Sleeping on your side is recommended. This improves blood circulation to your baby and is thought to reduce the possibility of stillbirths occurring.
If you don’t feel your baby’s movements, or if you notice a change in the pattern of movements for your baby, report this to your healthcare provider immediately.
Having a healthy lifestyle while pregnant has benefits for you, and gives your baby the best start in life.
How to deal with feelings of grief after a stillbirth?
Pregnancy loss at any time is traumatic for all involved. The woman, her family, and the healthcare providers caring for her often need to have extensive counseling, with ongoing support from a number of agencies.
One fantastic support network in Australia and the UK is SANDS. Please contact them if you have experienced the loss of your baby.
In the US, March of Dimes is the best contact for stillbirth support.
Having a dedicated and experienced carer to help you deal with your grief is vital.
You can read more in Stillbirth – What Expectant Parents Need To Know.