Stillbirth: a guide

Stillbirth: a guide

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Stillbirth: what is it?

A stillbirth is the birth of a baby after 20 weeks gestation or with a birthweight of 400 gm or more, who shows no signs of life. Many pregnancies will have been confirmed by 18 weeks. But if it isn't clear how far along a pregnancy is, doctors will call it a stillbirth if the baby weighs more than 400 gm.

Babies can be stillborn for many reasons. But some stillbirths happen for no known reason.

If a baby dies before birth during mid-late pregnancy, it's called an intrauterine death. If a baby dies during labour, it's called an intrapartum death. In both situations, the baby will be stillborn.

The death of a baby is an intensely sad and difficult experience for all parents. This experience can bring up intense feelings of grief, emptiness, anger, anxiety and depression. Every stillbirth is unique, and there's no one or right way to feel about it.

When you know your baby has died before birth

Sometimes a baby dies in mid-late pregnancy, and an obstetrician or midwife will confirm that this has happened. In this situation, the obstetrician or midwife will explain to you what has happened and support you as you receive this news.

The obstetrician or midwife will also talk with you about options for your baby's birth.

You will need to go through labour and birth so your baby can be born. This is usually a physically demanding and emotionally distressing time for you and your partner.

Your obstetrician might suggest an induction to bring on your labour. You have the option of using medical pain management options if that's what you would like.

After stillbirth: spending time with your baby

Spending time with your baby creates memories and lets you acknowledge that your baby was a real person and part of your family. Remembering and sharing these memories over time helps some people grieve. How you make memories of your baby is up to you and your family.

It's OK for you to take as long as you need. Try not to feel pressured by other people's expectations or experiences.

For example, you might want to spend time holding and cuddling your baby. You can also dress, bathe and take photos of your baby. You can name your baby, if you hadn't done this already.

If you have other children, depending on how old they are, you might also give them the chance to meet their sibling.

If you would like to spend a few days with your baby or take your baby home for a while, speak to your midwife, who can help to arrange this.

Doctors, midwives, social workers, pastoral carers and your chosen funeral directors will help you with the things you need and want to do after your baby's stillbirth.

With your permission, most hospitals will put some photos, footprints and a lock of your baby's hair into a memory box. You can take this box home with you when you leave the hospital. If you prefer, the hospital can look after this box until you feel ready to collect it.

Saying goodbye to your baby after stillbirth

When you're ready to say goodbye to your baby, your hospital and chosen funeral directors will coordinate your baby's move to the funeral home. Your baby will be cared for with dignity and respect, just like any other person.

While your baby is at the funeral home, you can still visit your baby up until the burial or cremation. Speak to your funeral director, who can arrange this for you.

There are many people and organisations that can support you after your baby's stillbirth. You might want to speak with a private bereavement counsellor. Or you could contact national support organisations like SANDS or Red Nose Grief and Loss. These organisations have support helplines that you can contact 24 hours a day, 7 days a week.

For women: your body after stillbirth

After a stillbirth, a woman's body undergoes normal post-birth changes. If you're a woman who has just experienced a stillbirth, it might help you to know what to expect.

After giving birth your body will generally bleed for another 5-10 days. See a GP or obstetrician if you have:

  • heavy bleeding that doesn't stop
  • severe abdominal cramps
  • signs of a fever.

Breast soreness
Because your body was expecting to care for and nurse a new baby, your breasts might already have started to show signs of producing milk - they might be larger, sore and tender. A firm bra and pain relief can help to reduce the discomfort, which should go away after a few weeks.

Waiting for your breasts to return to normal can be a physically and emotionally difficult time. Midwives can offer you advice and support.

If you have breast pain, swelling, warmth, fever and chills, it's important to see a GP as soon as possible. This might be the beginnings of mastitis. Mastitis can start from a blocked milk duct. Massaging any lumps or expressing a small amount of milk can help to reduce the lumpiness.

Try to avoid expressing too much milk because this encourages your body to make more milk. This might mean it'll take longer for your breasts to return to normal.

Understanding why your baby died

Your doctor might ask if you'd like to have an autopsy done on your baby to find out more about why your baby died. Knowing why a baby died helps some people grieve. The information can also help doctors give you advice about future pregnancies.

Sometimes an autopsy won't be able to tell you why your baby died. Even if the autopsy can't explain your baby's death, knowing you tried to find out why your baby died can be reassuring.

If you don't want to do an autopsy, there might be other examinations that doctors can do. Your doctor can explain if this is a possibility.

It can be hard to decide about having an autopsy done on your baby. Doctors, midwives, social workers and pastoral carers can support you in making the best choice for your family.

Stillbirth: risk factors

Often we don't know the exact cause of a stillbirth.

In Australia, risk factors for stillbirth include:

  • maternal overweight and obesity
  • advanced maternal age
  • sleep position in late pregnancy, particularly falling asleep on your back
  • complications during labour
  • problems with the placenta or umbilical cord
  • developmental abnormality or birth defect
  • maternal medical condition - for example, pre-eclampsia, diabetes or renal failure
  • lifestyle factors including smoking tobacco and drug and alcohol use in pregnancy
  • injuries caused by vehicle accidents, abuse or family violence.

Legal information about stillbirth

By law, all stillbirths in Australia must be registered with Births Deaths and Marriages in your state or territory. Visit your state or territory's Births Deaths and Marriages website for more information.

In most states and territories in Australia, it's also a legal requirement to arrange a burial or cremation for your stillborn baby.

In some cases, your baby's death might require a coroner's investigation to find out the cause of death. Hospital staff will guide you through this process if it needs to happen.

Help and support is available after stillbirth. For example, nurses offer a follow-up visit after a stillbirth to connect mothers and partners with local support groups.