Understanding Stillbirth - Intrauterine Death of the Baby

Understanding Stillbirth - Intrauterine Death of the Baby

Miscarriages are a common phenomenon worldwide. They are medically referred as spontaneous abortion which occurs before 20 weeks or first half of pregnancy. After this term, if a baby dies in the mother’s womb it’s known as the stillbirth.

Both miscarriages and stillbirth can be devastating for the prospective parents. So it is imperative to understand why it happens, warning signs and the most important aspect as to how to cope with it.

What causes stillbirth?

Stillbirth can happen to anyone during the pregnancy or during the labor process. In almost half of the total cases of stillbirth, the reasons are not clear. The remaining cases that have been understood so far are mentioned below:

Birth Defects

Just as many chromosomal abnormalities are responsible for majority of miscarriages, there are certain abnormalities or birth defects that can increase the chances of baby to be stillborn. Where chromosomal abnormalities are determined at the time of conception, birth defects can be due to various environmental factors.

For instance, folic acid deficiency can increase the risk of the baby developing neural defects such as anencephaly, in which crucial parts of the brain and skull fails to form. This accounts for 14 percent of stillbirths.

Intrauterine growth restriction

This is a condition in which baby is significantly smaller as against its age (the number of weeks). In serious cases, it can cause stillbirth or may be newborn loss. This can be due to lack of oxygen or other essential nutrients.

Placental abruption

When the placenta prematurely splits from the uterine wall, this is known as placental abruption. This occurs in about 1 percent of pregnancies but the risk of stillbirth would depend upon the degree of separation. If the separation is 50 percent or more, it often causes stillbirth.

Umbilical cord accidents

Umbilical cord accidents happen:

  • When there is a knot in the cordo When during or prior to labor, the cord comes out of vagina before the baby and becomes trapped against the baby’s body
  • When the baby gets strangulated due to cord coiled around the neck tightly. This happens in about 10 percent of the total stillbirth cases. But point to be remember here is that many babies have cord coiled around their neck (loosely) at the time of birth, but it does not always cause problem

Infections

In developed countries, stillbirth due to bacterial and viral infections account for about 24 percent of total cases. The common infections related to stillbirth are bacterial vaginosis, genital herpes, group B strep, syphilis, etc.

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Why India has the most stillborn cases?

Shocking, but true. With 5,92,000 stillbirth in 2015, India leads the world in terms of stillbirth, as per a report by medical journal Lancet. According to World Health Organization, a baby born with no signs of life at or after 28 weeks of gestation, is considered a stillbirth.

In India, the high numbers of cases are due to:

  • Lack of timely and quality ante-natal monitoring
  • Hypertension and diabetes
  • Nutritional factors such as anemia, malnutrition
  • Drinking and smoking
  • Poverty and other general living conditions

Are there any warning signs or symptoms?

Though stillbirth can occur without signs, doctors still advise tracking fetal kick counts at least once a day. If you suspect a problem in kick counts, then the doctor would advise you to undergo Non-Stress Test (NST) that checks the heart rate of the baby and uterine activity.

Secondly, just like adults, babies in the womb too have time when they are more active. Check yourself if your baby feels less active to you or overly active. If you suspect anything, call the doctor immediately. Other signs may include pain in abdomen and back or vaginal bleeding. In these cases, you should check with the doctor immediately.

Is it possible to prevent stillbirths?

Again it depends on the warnings signs and as it’s a crucial part of prenatal care, doctor advises a pregnant woman to check for any unusual symptoms. Moreover, when there is a risk factor such as high blood pressure, the doctor typically takes action to minimize the risk. This is the reason why prenatal care is so important.

Women who are at increased risk should talk to a perinatologist or an obstetrician who specializes in high-risk pregnancy.

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What happens when doctors discover that the baby has no heartbeat?

During prenatal checkup, if the doctor finds that the baby does not have a heartbeat, the doctor would want to confirm that with the ultrasound. And if it is confirmed that the baby has died, the woman has few choices. Either the doctor would recommend her to go for medical induced labor right away or can wait to see if she goes into labor on her own within a week or two.

The doctor might also go for C-section delivery if she sees any complications. Though stillbirth in the womb is not usually dangerous, there are risks of waiting that could result in blood clotting. So it is important to understand all the risk and benefits of these options.

Coping up after stillbirth

The tragedy of stillbirth leaves the parents in emptiness and feeling of lost. Coping with this is extremely difficult. One might find trouble in understanding what happened as all was going fine.

It’s completely normal to grieve

Grieving can be a long-term process, there are no deadlines. After all, for months you have nurtured a baby in your womb without seeing him face to face, you must be buying clothes, wondering what your baby will look like and what personality traits he or she will come with. So it’s completely ok to give yourself time, you have every right to grieve.

Dealing with the guilt

For most of the women, it’s hard not to feel guilt. You must be wondering what you could have done, what if you could have gone to the hospital sooner or should have been more careful. But as the case with early miscarriages, in most of the cases, stillbirth is not anyone’s fault. So it’s natural to think about it but the truth is none of these things might have made any difference.

Searching for answers

You might be searching for answers to all your concerns and queries. So talk to your doctor about determining the cause of stillbirth, it might help you prepare better for future pregnancies.

Naming the baby

Firstly, naming the baby is a great way to give him honor. Secondly, you and your loved ones might feel comfortable talking about the loss if your baby has a name. So go ahead and give the name you were already considering.

Signs of depression

Even healthy baby birth can result in ‘baby blues’. So it’s out of the question that losing your child does not produce intense emotions. It’s true that grieving is a long time process but you should be cautious about the warning signs of post-partum depression and other emotional changes that come with it.

Taking physical care of yourself 

After stillbirth, the world will feel confusing and you would not like to eat or feel difficulty in sleeping or lose interest in doing daily tasks. Remember, your body is weak and recovering from physical and hormonal changes of pregnancy. So eat a nutritious diet, drink lots of fluids and get enough rest for faster recovery and staying fit. It will help a lot in focusing on emotional health.

Future Pregnancies

It’s natural to be concern about the future pregnancies. And eventually, it is completely your choice to decide the right time to give another try to have a baby. So have a word with the doctor when you are ready, especially when the cause of stillbirth is something that could happen in future pregnancy.

You must take good care of yourself and must be cautious that the next pregnancy could come with surprise moments. Communicating with your doctor as well as your near and dear ones will help a lot.