When a baby dies before or during delivery it is known as a stillbirth. A stillbirth is different to a miscarriage which occurs if a baby dies before 24 complete weeks of pregnancy.
If it is suspected that a baby has died after 24 complete weeks of pregnancy, the health carer (usually a midwife or doctor) will try to listen for the baby’s heartbeat using a handheld doppler and, if the heartbeat cannot be heard, an ultrasound scan will be performed.
Both stillbirth and miscarriage can have a devastating impact on the parents of the baby and the parents are likely to require a lot of support.
What causes stillbirth?
The causes of stillbirth are different for each woman. Sometimes it can be caused by complications with the placenta (the organ which provides oxygen and nutrients to the baby) or problems with a medical condition of the mother; however not all stillbirths can be prevented and often there is no explanation or cause that can be found which is very distressing for the parents of the baby.
Known causes of stillbirth
The main known causes of stillbirth are;
- Placenta or umbilical cord problems (such as placental abruption which is where the placenta separates from the womb before the baby is born; and in instances where the umbilical cord becomes knotted or wrapped around the baby)
- Bleeding before or during labour
- Congenital/ genetic problem in the baby (ie the internal functioning of the baby’s body) whilst it develops
- Infections in either the mother or the baby
- A medical condition of the mother (for example if the mother experiences high blood pressure known as pre-eclampsia, or has diabetes)
- Where there is a premature birth (where the baby has not fully developed and whose body is too immature to survive)
- Complications during labour and birth
Risks of stillbirth
The risk of a stillbirth increases if the mother is over 35 years old; is clinically obese; has smoked, drank alcohol or misused drugs during the pregnancy; has a multiple pregnancy (eg twins); or has a pre-existing health condition such as high blood pressure, epilepsy or diabetes.
To reduce the risk of stillbirth the NHS recommends that you eat healthily during your pregnancy, keep active, if you are a smoker that you stop smoking, avoid alcohol and sleep on your side (rather than your back). Information should be provided to you by your health carer about reducing the risk of stillbirth during your antenatal appointments.
It is important the pregnant mother attends all antenatal appointments so that her own and her baby’s health can be monitored regularly throughout the pregnancy. The baby will be measured at each antenatal appointment to ensure that the baby is growing at a normal and steady rate. The growth of the baby will be plotted on a chart. If a baby is measuring small for dates or their growth pattern changes, this could be a sign that the placenta is not working properly and the baby has fetal growth restriction. These circumstances could indicate an increased risk of stillbirth and prompt further investigation.
It is also vitally important that the mother monitors her baby’s movements during the pregnancy and if any changes are noted, to seek medical attention straight away.
What happens to the baby if the baby dies before they are born?
If a baby dies in utero (which means within the womb and before birth) sometimes the mother will be advised by their health carer to wait for labour to start naturally. In some instances, labour will be induced (which means brought on with medication) and this is generally where there is a risk to the mother’s health and the baby needs to be delivered as soon as possible. In some cases, although rare, the baby will be delivered by caesarean section.
It is devastating news for the parents of a baby who has died before being born. Support should be offered by the hospital as decisions will need to be taken (such as funeral arrangements and deciding whether to accept tests that will be offered by the hospital to try and find out why your baby died). Testing generally will include blood tests, an examination of the umbilical cord and placenta, a test for infection and genetic testing. A post-mortem is also performed, if you agree to this, where an examination will take place of the baby’s organs. The Healthcare Safety Investigation Branch (HSIB) may also commence an investigation. HSIB investigate the majority of maternity incidents (including stillbirths after 37 weeks) with the aim to improve maternity services.
If you wish, you will be able to spend time with your baby after they are born. Bereavement support should be offered within the hospital. Counselling can also be offered either via your own GP or community midwife.
There are many charities who provide support for those affected by the death of a baby such as Sands (Stillbirth and neonatal death charity) and Tommy's organisation.
If a baby was born after 24 complete weeks of pregnancy then, by law, the stillbirth has to be registered. This must be done within 42 days of the birth at the Register Office.
How can we help?
Medical negligence claims often arise from mistreated infections; failures to correctly interpret test results; failures to regularly monitor the baby (either antenatally or during labour) or complications arising during the birth causing a delayed delivery of the baby.
Not all stillbirths can be prevented, but there are instances where a legal claim for birth injury compensation can be made. If you have suffered a stillbirth and feel your baby’s death could have been avoided, please get in contact with us to see how we might be able to help you.