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Stillbirth: Symptoms, diagnosis and prevention

What is stillbirth?

Stillbirth is when a baby is born dead after 24 weeks of pregnancy. The loss of a baby before the 24th week of pregnancy is called a miscarriage.

Stillbirth is surprisingly common affecting around 1 in 200 pregnancies in the UK.

The reasons for a stillbirth are not always known.

Many women who have a stillbirth will be able to have a healthy baby in their next pregnancy. It may help to prevent future problems if the cause of the stillbirth is investigated.

What causes stillbirth?

Often, there’s no known reason for a stillbirth.

Problems with the placenta, which nourishes the baby, can lead to a stillbirth in around two thirds of cases. In a placental abruption, the placenta separates too soon from the uterine wall.

In around 1 in 10 cases of stillbirth, the baby had a birth defect or congenital abnormality.

Other causes of stillbirth include:

  • Umbilical cord problems also cause stillbirths. In a prolapsed umbilical cord, the cord comes out of the vagina before the baby, blocking the oxygen supply before the baby can breathe on its own.
  • A mother’s medical condition that existed before or developed during the pregnancy can lead to stillbirth. Women are at increased risk if they have type 1 diabetes or untreated diabetes before or during pregnancy. High blood pressure - particularly pregnancy-induced high blood pressure or pre- eclampsia - is another major cause of stillbirth.
  • Sometimes the foetus may grow too slowly. This condition, called intrauterine growth restriction (IUGR), puts the foetus at risk of dying from lack of nutrition.

Other causes of stillbirth include the use of street drugs (especially cocaine), severe nutritional deficiencies, infection during pregnancy, and exposure to environmental agents such as pesticides and carbon monoxide.

If there is a history of thrombosis or pulmonary embolism either in the family or yourself, let your doctor know as certain defects in clotting can increase the risk.

Am I at risk of a stillbirth?

Factors that increase the risk of a stillbirth are alcohol use, drug abuse, and cigarette smoking. Obesity and a history of a previous stillbirth also increase a woman’s risk. Women who have certain medical conditions, such as diabetes or high blood pressure, face an increased chance of stillbirth, especially if these conditions aren’t under control. Girls under the age of 15 and women older than their mid-30s also have an increased risk of stillbirth.

How do I know if I will have a stillbirth?

There may be no warning signs.

If you're at risk of a stillbirth or if you experience decreased foetal movements, your doctor or midwife may arrange certain tests to make sure that your baby is healthy. These tests may include ultrasound and a cardiotocograph (CTG). The CTG involves putting a belt with a foetal monitor around your abdomen to record the foetal heartbeat on a strip of paper.

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