Pregnancy is a time of joyful anticipation for most prospective parents. For some, however, the pregnancy ends with the death of the baby while it is still in the womb. Death of the fetus before birth, called stillbirth, occurs once in about 200 pregnancies, according to the American Pregnancy Association. Stillbirths usually occur before labor begins, although in rare cases the baby dies during delivery.
Warning Signs
Reduced movement is a sign of fetal distress, says the March of Dimes. The pregnant woman may also bleed or experience contractions or other abdominal pains. An ultrasound test will confirm if the heart of the fetus has stopped beating.
Delivery
Labor contractions typically begin within two weeks of the death of the fetus, explains the March of Dimes. In most cases, labor is induced chemically soon after the death of the fetus is confirmed. Cesarean sections are rarely required. After the fetus is delivered, the fetus and placenta are examined to determine the cause of the stillbirth.
Causes
Poor fetal growth causes the largest percentage of stillbirths, says the March of Dimes. Problems with the placenta cause approximately 25 percent of stillbirths. The most common problem is placental abruption, in which the placenta separates from the uterine wall, causing heavy bleeding and starving the fetus of oxygen. Stillbirth may also be caused by birth defects, umbilical cord problems, such as a kink in the cord, or maternal infections, such as uterine or genital infections or certain viruses. Some chronic maternal health conditions, particularly high blood pressure, kidney disease or diabetes, also indirectly cause stillbirth by interfering with fetal growth or leading to placental abruption. Car accidents, falls and other trauma to the prospective mother may also result in fetal death. Occasionally, a lack of oxygen during delivery will cause a stillbirth.
Risk Factors
Women older than 35 are at risk for stillbirth, notes American Pregnancy Association. Women who are obese or pregnant with twins or other multiples are also at increased risk. Women of African-American descent are twice as likely as white women to have a stillbirth, says the March of Dimes. Hispanic women do not have an increased risk compared with women who are not Hispanic. Cigarette smoking and use of alcohol and street drugs during pregnancy also raise a woman's risk for a stillbirth.
Prevention
Health care providers monitor women who are at high risk for stillbirth, such as those with diabetes or high blood pressure, for signs of fetal distress, says the March of Dimes. Beginning at around week 32 of pregnancy, women at high risk for a stillbirth may count the number of times their fetus moves during a two-hour period. If the fetus moves fewer than 10 times, it may be in distress and the woman should seek immediate medical attention. The prospective mother should also seek immediate attention if the baby becomes less active than previously, or if she experiences vaginal bleeding. The March of Dimes advises women who have health conditions that may increase their risk of a stillbirth to consult with their health care provider prior to conception. For women who have had a stillbirth, subsequent pregnancies are likely to end with a healthy baby, although their risk of another stillbirth is slightly higher compared with women who have never had a stillbirth.
