Health A to Z
A stillbirth is a baby born dead after 24 completed weeks of pregnancy.
If the baby dies before 24 completed weeks, it's known as a miscarriage or late foetal loss.
Stillbirth is more common than many people think. There are more than 3,600 stillbirths every year in the UK, and one in every 200 births ends in a stillbirth. Eleven babies are stillborn every day in the UK, making it 15 times more common than cot death.
Around a half of all stillbirths are linked to placental complications. This means that for some reason the placenta (the organ that links the baby's blood supply to the mother's and nourishes the baby in the womb) isn't functioning properly.
About 10% of stillborn babies have some kind of birth defect that contributed to their death. A small percentage of stillbirths are caused by problems with the mother's health, for example pre-eclampsia, or other problems, including cord accidents and infections.
Read more about causes of stillbirth.
If it's suspected that your baby may have died during your pregnancy, a handheld Doppler device or an ultrasound scan can be used to check your baby's heartbeat.
If your baby has died and there's no immediate risk to your health, you'll usually be given time to think about what you want to do next.
You may be able to choose whether you would like to wait for labour to begin naturally, or if you want it to be started with medication (induced).
If your health is at risk, the baby may need to be delivered as soon as possible. It's rare for a stillborn baby to be delivered by caesarean section.
At this stage, it's common for parents to ask why their baby died. Those caring for you may give you some basic information about tests to try to find out why your baby died.
Read more about how stillbirths happen.
After a stillbirth, many parents want to see and hold their baby. You may also wish to give your baby a name and create memories by taking photographs or a lock of hair. It's completely up to you what you want to do. Decisions about what to do are very personal and there’s no right or wrong way to respond.
Finding out why a stillbirth has happened can be helpful with the grieving process and provide information if you want to get pregnant in the future, so you'll be offered tests to try to find out why your baby died.
By law, all stillborn babies have to be formally registered. In England and Wales, this must be done within 42 days of your baby's birth.
A senior doctor will discuss the test results and post-mortem (if you decided to have one) during a follow-up appointment several weeks after the birth. You may also want to discuss any possible effects on future pregnancies.
Read more about what happens after a stillbirth.
Stillbirth and late miscarriage can be devastating for the baby's parents, and they can also affect wider family members, including children and friends.
You may find it helpful to discuss your feelings with your GP, community midwife or health visitor, or with other parents who've lost a baby.
There are many support groups in the UK for bereaved parents and their families. Find bereavement support services in your area.
Some of these groups are run by parents who've experienced stillbirth, or by healthcare professionals, such as baby loss support workers or specialist midwives.
Not all stillbirths can be prevented. However, there are some things you can do to reduce your risk of having a stillbirth, such as:
Read more about preventing stillbirth.
If you have experienced a stillbirth, your clinical team may pass information about you on to the National Congenital Anomaly and Rare Diseases Registration Service (NCARDRS).
This helps scientists to understand more about this complication. You can opt out of the register at any time.
A large proportion of stillbirths seem to happen in otherwise healthy babies and the cause often can't be explained.
However, many stillbirths are linked to placental complications. This means that for some reason the placenta (the organ that links the baby's blood supply to the mother's and nourishes the baby in the womb) isn't functioning properly.
A poorly functioning placenta may be the direct cause of stillbirth, or it may contribute to it because the baby's growth has been held back.
If there have been problems with the placenta, stillborn babies are usually born perfectly formed, though often small. With more research, it's hoped that placental causes may become better understood, leading to better detection of placental problems and better care for these babies.
Other conditions that can cause stillbirth or may be associated with stillbirth include:
Around one in 10 stillbirths are caused by an infection. The most common type of infection is a bacterial infection that travels from the vagina into the womb (uterus). These bacteria include group B streptococcus, escherichia coli (E.coli), klebsiella, enterococcus, haemophilus influenza, chlamydia, and mycoplasma or ureaplasma.
Other infections that can cause stillbirths include:
There are also a number of things that may increase your risk of having a stillborn baby, including:
Your midwife will check the growth and wellbeing of your baby at each antenatal appointment, and they'll plot your baby's growth on a chart to ensure he or she is continuing to grow.
Every baby is different and should grow to the size that's normal for him or her (some babies are naturally small). However, all babies should continue to grow steadily throughout the pregnancy.
If a baby is smaller than expected, or his or her growth pattern tails off as the pregnancy continues, it may be because the placenta isn't working properly. This increases the risk of stillbirth.
Problems with a baby's growth should be picked up during antenatal appointments. However, it's important to be aware of your baby's movements and let your midwife know immediately if you notice a reduction in the baby’s movements.
See preventing stillbirth for more information.
Your baby's wellbeing will be monitored during your antenatal appointments, so any problems will usually be picked up before labour starts.
If it's suspected that your baby may have died, a midwife or doctor may initially try to listen to the baby’s heartbeat with a handheld Doppler device. An ultrasound scan will also be carried out to check your baby's heartbeat. A doctor will usually be asked to confirm that the baby has died by carrying out an ultrasound scan.
Sometimes, after the baby's death has been confirmed, a mother may still feel her baby moving. This can happen when the mother changes position. In this case the mother may be offered another ultrasound scan.
Finding out your baby has died is devastating. You should be offered support and your options should be explained to you. If you're alone in hospital, ask the staff to contact someone close to you and ask them to come in to be with you.
Read more about getting help after a stillbirth.
If a baby dies before labour starts, medication to start labour is usually offered. This is safer for the mother than having a Caesarean section.
If there's no medical reason for the baby to be born straight away, it may be possible to wait for labour to start naturally. This decision doesn't usually need to be made immediately and it may be possible to go home for a day or two first. In some cases, medication that prepares a woman’s body for the induction process may be recommended. This medication can take up to 48 hours to work.
While waiting for labour to begin naturally, regular blood tests are needed after 48 hours.
Waiting for labour to begin naturally also increases the chance of the baby deteriorating in the womb. This can affect how the baby looks when he or she is born, and can make it more difficult to find out what caused the death.
If the health of the mother is at risk, labour is nearly always induced using medication. This may been done immediately if:
Labour can be induced by inserting a pessary tablet or gel into the vagina, or by swallowing a tablet. Sometimes, medication is given through a drip into a vein in the arm.
After a stillbirth, most parents want to see and hold their baby. This is entirely up to you. You'll be given some quiet time with your baby if this is what you want.
You can also take photographs of your baby and collect mementos, such as a lock of hair, foot prints or hand prints, or the blanket that your baby was wrapped in at birth.
If you're not sure whether you want to take any mementos of your baby home, it's usually possible for them to be stored with your hospital records. If your hospital doesn't keep paper records, you may be given these mementos in a sealed envelope to store at home. This means you'll be able to look at them if you ever decide you want to.
You may also want to name your baby. However, not everyone does this and, again, it's up to you. Decisions about what to do are very personal and there’s no right or wrong to the way your respond.
You may be introduced to a bereavement support officer or a bereavement midwife. They usually work in hospitals or for the local council. They can help with any paperwork that needs to be completed and explain choices you can make about your baby's funeral. They'll also act as a point of contact for other healthcare professionals.
Read more about support after a stillbirth.
You'll be offered tests to find the cause of the stillbirth. You don't need to have these, but the results may help avoid problems in any future pregnancies.
The tests you're offered may include:
More in-depth tests can also be carried out on your baby to try to establish the cause of death, or whether there are any conditions that might have contributed to it. This is called a post-mortem.
A post-mortem is an examination of your baby's body. The examination can provide more information about why your baby died, which may be particularly important if you plan to become pregnant in the future.
A post-mortem can't go ahead without your written consent (permission), and you'll be asked if you want your baby to have one. The procedure can involve examining your baby's organs in detail, looking at blood and tissue samples, and carrying out genetic testing to see whether your baby had a genetic disease.
The healthcare professional asking for your consent should explain the different options to help you decide whether you want your baby to have a post-mortem.
By law, stillborn babies have to be formally registered. In England and Wales, this must be done within 42 days of your baby's birth, and in Scotland within 21 days.
In Northern Ireland, you don't have to register a stillbirth but you can if you want to, as long as it's within one year of the birth.
You'll usually have a follow-up appointment to check your health and discuss the post-mortem and test results (if carried out) a few weeks after you leave hospital.
This appointment is also an opportunity to talk with your doctor about possible future pregnancies. Before attending your follow-up appointment, you may find it helpful to write down any questions you have for your doctor.
Not all stillbirths can be prevented. However, there are some things you can do to reduce your risk.
Some of these are discussed in more detail below.
Obesity increases the risk of stillbirth.
The best way to protect your health and your baby's wellbeing is to lose weight before becoming pregnant. By reaching a healthy weight, you cut your risk of all the problems associated with obesity in pregnancy.
If you're obese when you become pregnant, your midwife or GP can give you advice about improving your health while pregnant.
Eating healthily and activities such as walking and swimming are good for all pregnant women. However, if you weren't active before becoming pregnant, consult your midwife or doctor before starting a new exercise programme while you're pregnant.
You'll usually start feeling some movement between weeks 16 and 20 of your pregnancy, although it can sometimes be later than this. These movements may be felt as a kick, flutter, swish or roll.
The number of movements tends to increase until 32 weeks of pregnancy and then stay about the same, although the type of movement may change as you get nearer to your due date. You should continue to feel your baby move up to and during labour.
If you notice your baby is moving less than usual, or if you've noticed a change in the pattern of movements, it may be the first sign that your baby is unwell. You should contact your midwife or local maternity unit immediately so your baby's wellbeing can be assessed.
There's no specific number of movements that's considered to be normal. What's important is noticing and telling your midwife about any reduction or change in your baby's normal movements.
The Royal College of Obstetricians and Gynaecologists (RCOG) has produced a leaflet called Your baby's movements in pregnancy (PDF, 138kb) which you may find useful.
Some foods should be avoided during pregnancy. For example, you shouldn't eat some types of fish or cheese, and you should make sure that all meat and poultry is cooked thoroughly.
Read more about the foods to avoid during pregnancy.
During your antenatal appointments, your midwife or GP will monitor your baby's development. They'll monitor your baby's growth and position.
You'll also be offered tests, including blood pressure tests and urine tests. These are used to detect any illnesses or conditions, such as pre-eclampsia, that may cause complications for you or your baby. Any necessary treatment can be provided promptly and efficiently.
Read more about antenatal care.
A stillbirth can be emotionally traumatic for both parents as well as other family members. Help and support is available.
You may find it helpful to discuss your feelings with your GP, community midwife or health visitor, or with other parents who've lost a baby.
Support groups can also help if you've had a stillbirth. Sands, the stillbirth and neonatal death charity, provide support for anyone affected by the death of a baby. The charity runs a helpline, provides information and support literature, and funds research into the causes of stillbirth.
You can call the confidential helpline on 020 7436 5881, or you can email firstname.lastname@example.org. The helpline is open from 9.30am to 5.30pm, Monday to Friday. It's also open later on Tuesday and Thursday evenings, from 6pm to 10pm.
There are many other self-help groups in the UK for bereaved parents and their families. You can search for bereavement support services in your area. These support groups are usually run by healthcare professionals, such as baby loss support workers or specialist midwives, and parents who've experienced stillbirth.
Some support groups are for women whose stillbirth has a specific cause. For example: