What is stillbirth?

In Australia, stillbirth is the birth of a baby who has died any time from 20 weeks into the pregnancy. The baby may have died during the pregnancy or, less commonly, during birth.

If the length of pregnancy is not known, the birth will be considered a stillbirth if the baby weighs 400 grams or more.

A miscarriage is when a pregnancy ends before 20 weeks of pregnancy.

Every day in Australia, 6 babies are stillborn.

What can cause stillbirth?

Unfortunately, we often don’t known what causes a stillbirth.

Some of the possible causes of stillbirth include the following.

• Congenital abnormalities, such as a genetic condition or heart condition.
• A premature birth, where the baby is too immature to survive.
• A medical condition in the mother, such as diabetes, high blood pressure in pregnancy or pre-eclampsia.
• Problems that can cause bleeding during pregnancy, such as placental abruption or placenta praevia.
• Complications during birth.
• Certain infections.
• Problems with the umbilical cord or placenta.
• Major injury or trauma to the mother's abdomen (the tummy area).

You should be checked early in pregnancy for potential problems. This is so that they can be closely monitored. Your doctor and midwife will talk with you about monitoring and the best timing for the birth of your baby.

Can the risk of a stillbirth be reduced?

In many cases, the cause of stillbirth is not known. But there are some things you can do that can help lower the risk of stillbirth.

• Avoid smoking while pregnant. Smoking in pregnancy is one of the main causes of stillbirth. Quitting at any time reduces the risk of harm to your baby.
• Go to your antenatal appointments, where your doctor or midwife can check your baby’s growth. Regular ultrasound scans may be recommended if your baby isn't growing as expected.
• Be aware of your baby's movements, especially in the third trimester. Get to know the usual pattern of your baby’s movements. If you think your baby's movements have changed, speak to your doctor or midwife immediately.
• Go to sleep on your side as your pregnancy progresses, especially from 28 weeks. Lying on your back puts pressure on major blood vessels. This can reduce the flow of blood to your womb and restrict your baby’s oxygen supply. Research has shown that going to sleep on your side can halve the risk of stillbirth compared to going to sleep on your back.

Your doctor will talk with you about the timing of your birth if you have any risk factors.

When should I see my doctor?

Contact your doctor or midwife immediately if you are pregnant and:

• you think your baby has stopped moving or is moving differently or less than usual
• you have strong pain or cramping in your abdomen or back
• you receive a hard knock or blow to your abdomen
• you are bleeding or have more discharge than normal from your vagina
• you feel dizzy, experience changes to your vision, or have severe or long-lasting headaches
• your face, feet or hands suddenly swell or you have painful swelling in your legs
• you have severe or ongoing nausea and vomiting that affects your eating or drinking
• you have a fever or chills
• you sense that something doesn't feel right

If you can't contact your doctor or midwife, go to the local hospital emergency department. If you think it is an emergency, phone triple zero (000) for an ambulance.

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How is a stillbirth diagnosed?

A stillbirth is diagnosed if your baby’s heart has stopped beating. During pregnancy, this can be detected with an ultrasound scan.

An obstetrician or midwife will let you know if your baby is not showing any signs of life. They will support you while they give you this news.

Grieving the loss of a baby is a very traumatic experience. It’s normal to feel a range of emotions, including shock, disbelief, deep sadness, anger and emptiness. There is no right or wrong way to feel and it’s okay for you to take as much time as you need.

How is the baby usually delivered?

If you are still pregnant, you will need to give birth to your baby. This is an extremely traumatic time for parents.

Your midwife or obstetrician will discuss with you the best way for you to give birth and the types of pain relief available. You may be able to go home for a day or 2 before coming back to the hospital to give birth to your baby.

In most cases, they will suggest inducing a vaginal birth rather than a caesarean birth. Your feelings are important as well as your preferences about the birth. Your care team will support you during and after the birth. Your care team will also discuss with you some options for after the baby is born.

Resources and support

The death of a baby is highly distressing, and grief is a normal response to stillbirth. Unfortunately, many bereaved parents report feeling isolated in their grief, and that the magnitude of their loss is not well understood.

Support is very important for parents and families who have experienced a stillbirth. There is an increased risk of parents having mental health issues such as anxiety, depression and post-traumatic stress.

If you have experienced stillbirth you can get support from SANDS Australia by calling 1300 308 307, 24 hours a day.

Still Aware is an Australian stillbirth awareness organisation, providing education and support to parents and health professionals.

Stillbirth Foundation Australia also has information and support for families and health professionals.