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How Do I Know If I Will Have a Stillbirth?

Fortunately, stillbirths happen rarely, but if they occur, many of them take place prior to labor. They often happen to women who have no specific risks, and there are usually no warning signals. Sometimes there may be certain warning signals that a stillbirth may occur. Let your doctor know right away if fetal movements become fewer or they stop altogether.

If you are at risk for a stillbirth or if you experience decreased fetal movements, your doctor may regularly order certain tests to make sure that the fetus is OK. These tests may include an ultrasound examination and a test called a "non-stress test" or NST. The NST involves putting a belt with a fetal monitor around the uterus which records the fetal heartbeat on a strip of paper. A "reactive" NST usually means a decreased risk of stillbirth over the next week or so.

Testing For Reasons of the Stillbirth

After the delivery of a stillborn baby, your doctor may ask your permission to examine its body to find out what went wrong. A specially trained doctor called a pathologist will perform an autopsy and special tests including genetic testing. The results may help you find out your risks for your next pregnancy and provide some comfort by answering questions about the baby's death. This evaluation should not interfere with any plans you would like to make for a memorial. It is a personal decision that you should make after discussing the procedure with your doctor and supportive family members. You may also find it helpful to consult a mental-health professional.

If the stillbirth is due to a genetic disorder, you may be referred to a genetic counselor. A genetic counselor will review your medical and family history and provide information about the risk of birth defects in future pregnancies.

What Are the Treatments?

If your doctor tells you your fetus is dead, there are usually several options how to deliver the baby. There is usually no need to do this immediately unless there are complications. More often than not, labor will likely begin on its own within one to two weeks. If several weeks have passed without spontaneous labor, your doctor will probably want to induce labor. You may prefer to induce labor earlier. Most stillborn babies can be delivered normally after induction of labor unless there are specific reasons for cesarean section.

Before entering the hospital, consider whether you want special arrangements. You may want a private room or a room that is not near other women having babies. Think about whether you want to see your baby, name it or have photographs taken. This has been a common practice since the 1980s under the belief that doing so helped women adjust to the loss. Recently, a British study found that doing this actually increased the risk of becoming depressed or having posttraumatic stress disorder. The researchers found that having a funeral and keeping mementos did not cause any problems.

After a stillbirth, as with other deliveries, you may experience breast engorgement, discomfort from an episiotomy, postpartum depression and other problems. The combination of recovering physically and emotionally may seem overwhelming.

A stillbirth is an emotionally wrenching experience. A qualified psychologist or psychiatrist can help you and your family through this difficult time.

Guilt is a common reaction. Keep in mind that stillbirths are rarely if ever caused by something you did or did not do. It's normal to experience deep grief, anger and confusion. The loss of your child may strain your marriage. This is only one of the areas in which a mental-health professional can offer a great deal of help.

Consider joining a support group where you can talk about your feelings with other parents who are coping with the death of a baby.

Several organizations offer support. These include:

• The Compassionate Friends, (877) 969-0010.
• Mothers in Sympathy and Support (MISS), which provides support to both mothers and fathers. (623) 979-1000
• SHARE Pregnancy and Infant Loss Support Inc., (800) 821-6819.

You may want to wait some time before getting pregnant again. Some women who get pregnant in the first 12 months after a stillbirth experience high levels of anxiety and depression, both during the pregnancy and up to a year after the birth of a healthy baby.

Depending on the cause of the stillbirth, you may be a "high risk" pregnancy the next time you get pregnant. Seeing a high risk obstetrician or "maternal-fetal medicine" specialist may help you map out a plan to ensure proper monitoring of you fetus in the next pregnancy.