Stillbirth: causes, diagnosis, and support
Overview of stillbirth, how it differs from miscarriage, common causes, diagnosis and management, prevention strategies, and bereavement support; definitions vary by country (20–24 weeks).
Overview
Stillbirth refers to the death of a fetus before or during delivery after a gestational age threshold that varies by jurisdiction, commonly defined as occurring at or after about 20 to 24 weeks of pregnancy. The term applies when the unborn baby has no signs of life at birth. For clarity, the word fetus is used for the developing baby in utero, and stillbirth is distinct from earlier pregnancy loss often called a miscarriage. Definitions and reporting requirements differ between countries and health systems.
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7 ImagesCauses and characteristics
Many different conditions and events can lead to stillbirth. Commonly reported contributors include problems with the placenta or umbilical cord, congenital anomalies, maternal medical conditions such as high blood pressure or uncontrolled diabetes, and infections. Lifestyle factors like smoking and substance use are associated with increased risk. Sometimes no clear cause is identified despite detailed investigation.
Diagnosis, delivery, and investigation
A stillbirth is typically suspected when fetal movements stop and confirmed by clinical assessment and ultrasound demonstrating absence of a fetal heartbeat. Management depends on gestational age, maternal health, and local guidance; when the fetus has died before labor, mothers are often offered induction of labor or, in some circumstances, cesarean delivery. After birth, investigations may include examination of the placenta, maternal blood tests, infection screening, genetic testing, and, when agreed, fetal autopsy to try to determine the cause.
Differences, legal definitions, and reporting
It is important to distinguish stillbirth from neonatal death (death after live birth) and from early pregnancy loss. Legal definitions and whether an event is registered as a stillbirth vary; some countries set the threshold at 20 weeks, others at 24 weeks or a minimum birth weight. Healthcare providers follow local rules for certification, bereavement care, and data reporting. Further information about childbirth practices is available from resources on labor and delivery childbirth.
Support, prevention, and important considerations
Preventive strategies focus on good antenatal care: management of chronic conditions, screening for infections, monitoring fetal growth and movement, and counseling about smoking and substance use. After a stillbirth, families need compassionate bereavement support, clear information about investigations, and follow-up care for future pregnancies. Many hospitals offer multidisciplinary teams that include midwives, obstetricians, perinatal pathologists, and mental health professionals.
Notable facts
- Not all causes are identifiable; placental examination often provides useful information.
- Emotional impact is profound; timely counseling and peer support can aid recovery.
- Terminology and thresholds differ internationally—check local guidance for specifics.
For further reading or support, consult local health services and perinatal bereavement resources, and ask care providers about investigations and options after a loss.
Questions and answers
Q: What is stillbirth?
A: Stillbirth is when a fetus dies while still inside the mother or during delivery.
Q: How is a stillborn baby different from a miscarried baby?
A: A stillborn baby has been living inside its mother for 20 to 24 weeks, whereas a miscarried baby lived inside the mother for less time.
Q: What is the term used for a delivered stillborn baby?
A: The delivered stillborn baby is stillborn.
Q: What causes stillbirth?
A: There are several possible causes of stillbirth, including problems with the placenta, infections, birth defects, and poor fetal growth.
Q: Can stillbirth be prevented?
A: Some causes of stillbirth are preventable, such as avoiding smoking and drug use during pregnancy and managing medical conditions like diabetes. However, many stillbirths cannot be prevented.
Q: How common is stillbirth?
A: Stillbirth is a rare event, occurring in approximately 1 in every 160 pregnancies in high-income countries and in approximately 1 in every 40 pregnancies in low- and middle-income countries.
Q: What is the difference between stillbirth and infant mortality?
A: Stillbirth is the death of a fetus before or during delivery, whereas infant mortality refers to the death of a baby before their first birthday, including deaths in the neonatal period (first 28 days of life).
Related articles
Author
AlegsaOnline.com Stillbirth: causes, diagnosis, and support Leandro Alegsa
URL: https://en.alegsaonline.com/art/93938
Sources
- cs.nsw.gov.au : "Department of Neonatal Medicine Protocol Book: Royal Prince Alfred Hospital"
- gro.gov.uk : Guide to registering stillbirths in the UK
- cdc.gov : State Definitions and Reporting Requirements
- preginst.com : Pregnancy Institute
- marchofdimes.com : March of Dimes: Quick reference and fact sheet
- fn.bmjjournals.com : Investigating perinatal death: a review of the options when autopsy consent is refused.
- bbc.co.uk : Stillbirth at h2g2 - written by a bereaved mother