When Your Baby Is Stillborn

Wisconsin Stillbirth Service Program
When your baby is stillborn, expectations , hopes and dreams are cruelly shattered and lives are changed. Many parents have initial feelings of shock and confusion when told that their baby has died. What happened? Why you? Babies are not supposed to die. When they do, it can be devastating, overwhelming, and painful. We are very sorry that your baby died. No one can take away the pain, but we hope the following information will answer some questions, provide reassurance, and help you.

What Is Stillbirth?

You may not have heard of stillbirth until you experienced it. When a baby dies before delivery, many people commonly think of miscarriage. Both stillbirth and miscarriage are types of pregnancy loss, but they differ by when the loss occurs. A miscarriage (sometimes called a spontaneous abortion) is when a baby dies before the 20th week of pregnancy. Stillbirth is the death of a baby after the 20th week of pregnancy but before delivery. Whenever parents deal with the death of their baby, whether it be early in pregnancy, late in pregnancy, or sometime after birth, there can be a great sense of disappointment, loss, and suffering. Stillbirth and miscarriage are separately defined not because one or the other is an easier or more difficult loss with which to deal, but because they differ in many ways. Stillbirth and miscarriage have different causes, need different evaluations, and differ medically and in the ways that parents and families can best be helped.

Stillbirth is common. It may affect anyone. There is no way to predict when stillbirth will happen or who will experience it. Stillbirth occurs in families of all races, religions, and income levels. Each year in the United States about 25,000 babies, or 68 babies every day, are born still. This is about 1 stillbirth in every 115 births. Most often a stillbirth is detected while the baby is in the mother’s uterus, sometimes not until labor is underway.

Why Was Your Baby Stillborn?

Following a stillbirth, parents frequently ask, "Why did this happen?" Sometimes a reason is found; other times a specific cause remains unknown. Extensive and careful evaluation of the baby and placenta following delivery may help identify a reason in about 40%-50% of stillbirths. When a specific cause is not identified, evaluation may still be helpful by at least ruling out potential high risks for recurrence.

Identifiable causes of stillbirth generally fall into one of three different categories: birth defects in the baby, problems with the placenta or umbilical cord, or maternal illnesses or conditions which may sometimes affect pregnancy.

• Birth defects are common but often overlooked causes for stillbirth. About one-fourth of babies who are stillborn have one or more birth defects that are responsible for their death.

• The placenta and umbilical cord are the baby’s "lifeline" for oxygen and nutrients. Problems in either one may completely cut off or severely interfere with the needed flow of blood, oxygen, and nutrients to the baby. Although commonly pointed to as the likely cause for death of a baby, problems with the placenta or umbilical cord actually account for only a moderate number of stillbirths.

• Although uncommon, maternal conditions may be responsible for stillbirth. Certain illnesses in the mother, such as diabetes or hypertension, and their treatments, sometimes cause stillbirths. An increased risk for stillbirth is also associated with the use of certain recreational drugs, particularly cocaine.

In addition, there are many other rare causes of stillbirth. Whether or not a specific cause for your baby’s death is identified, it is most important to remember that stillbirths most often are not caused by something you did or did not do.

What Is Involved In An Extensive Evaluation Of The Baby?

Following delivery of a stillborn, parents may be asked to provide consent for extensive evaluation of their baby. This evaluation involves many different studies, including an internal post-mortem examination (autopsy), a physical examination, photographs of the baby’s face, body, and any unusual features, X-rays, and genetic testing of some of the baby’s tissues. If permission is given, evaluations are started soon after the baby’s delivery. Detailed results are usually available and communicated to parents in a few weeks to a few months.

These studies can be helpful for many reasons. They may provide answers or insight to some of your questions including the frequently asked, "Why did it happen?" and "Will it happen again?", as well as those about management and care in future pregnancies. Even if some questions remain unanswered, there may be comfort in knowing that as much as possible was learned about the baby and that important information may be added to medical knowledge which could help other babies in the future. The baby is treated respectfully at all times. Agreeing to a comprehensive evaluation does not prevent a family from spending time with their baby or choosing to have a funeral, memorial service, cremation, or burial.

Such evaluation is valuable to most parents as they try to deal with the full impact of their loss. In fact, very few parents express regret for having the suggested evaluations done. Nevertheless, some may think that such assessment violates their baby and intrudes upon their grief. Parents must choose what is best for them. Whatever the decision, it is respected.

What About Future Pregnancies? Will Stillbirth Happen Again?

Generally one stillbirth does not predict another. On average, there is approximately a 3% chance for stillbirth to happen again in the next pregnancy—or approximately a 97% chance that a future pregnancy would not end in stillbirth. Extensive evaluation of the baby may provide information that allows a geneticist, genetics counselor, or your doctor to determine more accurately what the chances are that stillbirth could happen again. Finding a specific cause may imply a much higher or lower risk than this average one. Specific causes, when discovered, more often result in a decrease in the estimated risk that stillbirth may happen again and less often in an increase in that estimated risk. In almost all circumstances, subsequent healthy pregnancies are possible.

Making Sense Of What Happened

In the natural course of life events, babies are least of all expected to die. The loss of a baby through stillbirth can be overwhelming and devastating. Although surprising to some, the stillbirth of a baby is a great loss, as great as that of an older child or any loved one.

When stillbirth occurs, parents who were anxiously awaiting a baby suddenly are not. It is natural for you to grieve deeply for your baby who has died and for the hopes, dreams, and wishes that will never be; hopes, dreams, and wishes that, for you, were real long before the anticipated birth of your baby. You may feel a strong sense of sadness, anger, or maybe bitterness at the unfairness of this tragedy. You may experience feelings of loneliness and longing, helplessness, or, because of the intensity of your emotions, confusion. Many parents also feel guilt. They often wonder if they did something to cause their baby’s death; this is rarely true.

These intense emotions are real and a normal part of grieving. Grieving is a process of making meaning out of your loss and of life without your baby. Grieving is not easy. It is long, unpredictable, and requires a lot of energy. But you need time to grieve since grieving is necessary to work through pain toward healing.

Coping With Your Loss

Dealing with the death of your baby may be one of the most painful experiences in your life. Everyone copes and mourns differently. Perhaps a few of the following suggestions can help you survive some of the difficult times.

• Take care of yourself. Eat well. Get plenty of rest. Stay well physically so that you can continue to heal emotionally.

• Express yourself. Talk about your baby, your feelings, your fears, your grief. Or keep a diary, write a journal, create, start a flower garden. This may help you to see things more clearly.

• Read written resources. There are many books, articles, poems, and videos that can provide information, guidance, and support.

• Find a support network. Such a network may be your family, your friends, or your faith community. You may want to contact a support group for parents who have experienced the death of a baby, to share your story and feelings and to learn from others who have also "been there".

Above all, give yourself time. Be patient. You will never forget your baby, but you will heal. Healing is an ongoing process; it does not happen overnight. But it will happen.

For More Help:

Support:

Share. National Office, St. Joseph Health Center, 300 First Capitol Dr., St. Charles, MO 63301-2893; 800-821-6819.

Pen Parents, Inc. P.O. Box 8738, Reno, NV 89507-8738; 702-826-7332

Suggested Reading Material:

Empty Cradle, Broken Heart, by Deborah L. Davis, Ph.D., Fulcrum Press, 1996 (second edition).

A Silent Sorrow: Pregnancy Loss. Guidance and Support for You and Your Family, by Ingrid Kohn, M.S.W. and Perry-Lynn Moffitt, Dell Publishing, 1993.

Empty Arms: Coping with Miscarriage, Stillbirth and Infant Death, by Sherokee Ilse, Wintergreen Press, 1990.

When Pregnancy Fails: Families Coping With Miscarriage, Stillbirth, and Infant Death, by Susan Borg and Judith Lasker, Beacon Press, 1988 (second edition).

This educational pamphlet was written by Patricia L. Leh, M.S., Catherine A. Reiser, M.S., and Richard M. Pauli. M.D., Ph.D. as part of the continuing education activities of the Wisconsin Stillbirth Service Program. WiSSP is dedicated to serving families who experience the tragedy of stillbirth and the professionals who care for them—in Wisconsin and throughout the world.

Wisconsin Stillbirth Service Program
University of Wisconsin–Madison
Clinical Genetics Center
1500 Highland Avenue
Madison, WI 53705-2280
Phone: 608-262-6228
http://www.wisc.edu/wissp

Production of this pamphlet was made possible by funding from the Perinatal Foundation. Portions of WiSSP activities have been supported by Maternal and Child Health Funds from the State of Wisconsin.

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