Understanding Stillbirth - the Basics

What Is Stillbirth?

Stillbirth is the delivery, after the 20th week of pregnancy, of a baby who has died. Loss of a fetus before the 20th week of pregnancy is called a miscarriage.

A baby is stillborn in about 1 in 200 pregnancies. Because many stillbirths occur in what appear to be normal pregnancies, the parents-to-be are rarely prepared for this devastating outcome.

Most women who have a stillbirth will be able to have a healthy baby in their next pregnancy. If the stillbirth was caused by a chromosomal or umbilical cord problem, the chances of recurrence are small. If the cause was a chronic maternal illness or a genetic disorder, the risk is somewhat higher. On average, the chance of a successful future pregnancy is more than 90%.

What Causes Stillbirth?

Often, there's no known reason for a stillbirth. In about half of all cases, the specific cause for a stillbirth is unknown.

• One of the most important known causes is birth defects, with or without a chromosomal abnormality.
• Umbilical cord problems also cause stillbirths. In a prolapsed umbilical cord, the cord comes out of the vagina before the baby, blocking the oxygen supply before the baby can breathe on its own.
• Problems with the placenta, which nourishes the baby, can sometimes lead to a stillbirth. In a placental abruption, the placenta separates too soon from the uterine wall.
• A mother's medical condition that existed before or developed during the pregnancy can lead to stillbirth. Women are at increased risk if they have insulin-dependent diabetes or untreated diabetes before or during pregnancy. High blood pressure -- particularly pregnancy-induced high blood pressure or preeclampsia -- is another major cause of stillbirth.
• Sometimes the fetus may grow too slowly. This condition, called intrauterine growth restriction or IUGR, puts the fetus at risk of dying from lack of nutrition.
• Other causes of stillbirth include the use of street drugs (especially cocaine), severe nutritional deficiencies, infections during pregnancy, and exposure to environmental agents such as pesticides or carbon monoxide. 
• If there is a history of thromosis, thrombophlebitis, or pulmonary embolism either in the family or yourself, let your health care provider know as certain defects in clotting can increase the risk of total loss.

Am I at Risk for a Stillbirth?

Factors that increase the risk of a stillbirth are alcohol use, drug abuse, and cigarette smoking. Obesity and a history of a previous stillbirth also increase a woman's risk. Women who have certain medical conditions, such as diabetes or high blood pressure, face an increased chance of stillbirth -- especially if these conditions aren't under control. Teens under the age of 15 and women older than their mid-30s also have an increased risk of stillbirth.