The National Institutes of Health defines a stillbirth as the loss of a pregnancy--because of natural causes--after the 20th week of gestation. The March of Dimes reports that one out of every 160 pregnancies results in a stillbirth. The loss of a pregnancy often leaves couples asking many questions.
Why
The first question a woman may have following a stillbirth is why. There might be a sense of guilt that she caused the stillbirth through some fault or action. However, the American Pregnancy Association explains that the most common reasons for a stillbirth have little to do with outside influences. Placental abruption or a blood pressure condition known as preeclampsia can lead to a fetal demise. Sometimes the stillbirth is a result of chromosomal birth defects that would have prevented the fetus from living once born. Bacterial infections, umbilical cord accidents, a pregnancy that goes past 42 weeks and chronic medical conditions such as maternal diabetes can all be contributing factors to an early termination. Sometimes, there is no clear explanation for the loss of the pregnancy.
Diagnosis
Often a woman may notice that the fetal activity has slowed or stopped. A doctor will do an ultrasound to confirm whether the heart is still beating. An ultrasound may also help determine why the pregnancy terminated early.
Delivery
According to the March of Dimes, the physician will discuss all the options with the family. A woman may choose to wait until she goes into labor naturally to deliver. This usually occurs within two weeks of the stillbirth. Some women may want to give birth immediately following the news that the pregnancy has ended. If a woman's cervix isn't dilated, the physician can give her medications to prepare the cervix and a drug called pitocin to induce contractions. A woman will then deliver the fetus vaginally. A cesarean is rarely needed in stillbirths unless there is a condition that threatens the health of the mother.
Grieving
The loss of a pregnancy can be devastating. The Mayo Clinic advises that couples need time to grieve the loss. People cope with loss in many different ways and this can often cause strain on a couple. Many couples choose to honor the baby they lost with funerals, websites or memorials. Some couples may find grief counseling or group therapy helpful, while others may choose to lean on family, friends or clergy to help them through. There are often local resources available and the couple's obstetrician can point them in the right direction.
At Risk
According to the March of Dimes, women at high risk for stillbirth include women over 35, women carrying multiple fetuses, women with chronic health problems such as diabetes, women of African-American descent and women who are medically obese. High-risk pregnancies are monitored closely after the 32nd week for complications. Starting at about week 28, women can do kick counts. This means how many times the baby moves in an hour or how long it takes the baby to move, for example, 10 times. If a fetus moves 10 times within two hours this is normal. If there is less movement, the obstetrician should be notified.
