If miscarriage is considered a taboo topic, conversations surrounding stillbirth may as well be forbidden. The topic is such a sensitive one that people often don’t—or can’t—find the best way to discuss it.
But stillbirth, unfortunately, happens. And those who experience need support. Even those who are experiencing a healthy pregnancy may wonder and worry about having a stillborn baby. So it’s important to find a way to talk about these tough topics.
In this post, we’ll define stillbirth, discuss the differences between a miscarriage and a stillborn baby, outline various causes of stillbirth, identify warning signs, and explain how kick counts can help uncover a problem.
What is a stillbirth?
The Centers for Disease Control and Prevention (CDC) define stillbirth as the death of a baby after 20 weeks of pregnancy before or during delivery.
There are three different types of stillbirth: an early stillbirth, a late stillbirth, and a term stillbirth. An early stillbirth occurs when a fetus dies between 20 and 27 completed weeks of pregnancy; a late stillbirth occurs when a fetus dies between 28 and 36 completed weeks of pregnancy; and a term stillbirth occurs after 37 or more completed weeks of pregnancy.
The differences between a miscarriage and stillbirth
Though the loss of a baby during pregnancy is always profound, there are distinct differences between a miscarriage and a stillbirth.
Generally, miscarriage is a term that’s used to define a spontaneous pregnancy loss before 20 weeks gestation. Before 13 weeks—a time when most miscarriages occur—a miscarriage may also be called early pregnancy loss.
Early pregnancy loss occurs in approximately 10 percent of known pregnancies, according to The American College of Obstetricians and Gynecologists (ACOG)
Once a pregnancy has progressed past 13 weeks, miscarriage is uncommon but possible. A miscarriage after 13 weeks, but before 20 weeks is often referred to as a late miscarriage—or a second trimester miscarriage.
Once 20 weeks of pregnancy are complete, a loss of the pregnancy is no longer considered a miscarriage—it’s called a stillbirth.
What causes stillbirth?
Many women blame themselves when they experience a late pregnancy loss—they may ask themselves what they did wrong—but, according to the CDC, stillbirth is rarely the mother’s fault. In fact, it’s often impossible to pinpoint the exact cause of a stillbirth. That said, certain factors can put a woman at greater risk of having a stillborn baby, and knowing whether or not you are at risk can improve your chances of delivering a healthy, full-term baby.
- Certain medical conditions: Obesity, high blood pressure (including preeclampsia), and diabetes can all increase a woman’s chance of having a stillborn baby.
- Multiples: Being pregnant with twins, triplets, or more babies can increase the risk of stillbirth.
- Problems with the placenta: According to the National Institute of Child Health and Human Development (NICHD), one in four stillbirths can be attributed to a problem with the placenta, such as placental abruption (when the placenta detaches from the uterus, depriving the fetus of oxygen and nutrients) or insufficient blood flow to the placenta.
- Problems with the umbilical cord: When the umbilical cord knots or gets squeezed, it can deprive the fetus of oxygen and cause death. This occurs in approximately 1 in 10 stillbirths, according to the NICHD.
- Maternal demographics: Women younger than 20 and older than 35, those with lower socioeconomic status, those who smoke, those who are unmarried, and African American women are more likely to have a stillborn baby.
- History of miscarriage or stillbirth: Women who have experienced prior pregnancy loss, whether miscarriage or stillbirth, are more likely to experience it again. Future pregnancies should be monitored by a healthcare professional.
- Birth defects: Genetic problems are to blame for approximately 1 in every 10 stillborn babies.
- Infection: Infections like listeria or certain types of sexually transmitted infections in the fetus, placenta, or mother are responsible for more than 1 in every 10 stillbirths, according to the March of Dimes and the NICHD.
How common are stillbirths?
Stillbirth happens in about 1 percent of all pregnancies, according the the March of Dimes. This means that approximately or 24,000 babies—or 1 in 100 pregnancies—in the United States each year are stillborn.
Signs of stillbirth
Unfortunately, one of the scariest things about stillbirths is that a pregnancy can appear to be normal. Although a woman doesn’t often experience any signs of stillbirth and generally can’t prevent a stillbirth, pain, cramping, or bleeding can (but doesn’t always) indicate a problem.
Decreased or lack of fetal movement, however, is the biggest indicator of a stillborn baby.
If you suspect a problem…
Try kick counts
Decreased or lack of fetal movement should be taken seriously, as it can signal stillbirth.
You can monitor fetal movement at home by doing kick counts, or monitoring baby’s movements. You can get more information about how to do kick counts here, but it’s generally very simple–you count the number of times your baby moves (rolls, punches, or kicks).
You can start counting kicks around week 28. Pick a time of day when baby is most active, assume a comfortable position, and see how long it takes your baby to move 10 times (generally babies will move 10 times within about 30 minutes, though this can vary). After a few sessions, you’ll establish a baseline, or a normal rate of movement for your baby.
If your kick count changes dramatically or if you can’t feel your baby move at least 10 times within two hours, consult your healthcare provider. They may decide to do an ultrasound or attach a fetal monitor to your abdomen to check on the health of the baby.
How about you?
Do you have a story of infant loss? You are not alone. Many women experience some sort of loss during pregnancy—and any miscarriage or stillbirth is difficult to process. For some, talking about the experience can be therapeutic. If you’d like to share your story, feel free to do so in the comments below.