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.

Causes 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.

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.