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Pregnancy loss

  • Many women have a miscarriage or other kinds of pregnancy loss.
  • Give yourself time to grieve and heal.
  • Talk to your provider about what happened in your pregnancy.
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Stillbirth

Stillbirth is when a baby dies in the womb after 20 weeks of pregnancy. Most stillbirths happen before a woman goes into labor, but a small number happen during labor and birth. Stillbirth affects about 23,600 babies each year in the United States. This means stillbirth affects about 1 in 160 pregnancies (less than 1 percent).

Here’s what you need to know about stillbirth:

  • We know that certain infections and pregnancy complications can cause stillbirth, but we don’t know all the causes.
  • Some women are more likely than others to have a stillborn baby. You may be able to help reduce your risk to help you have a healthy baby.
  • Most women who have a stillbirth and get pregnant again later can have a healthy pregnancy and a healthy baby. 

What makes a woman more likely than others to have a stillbirth? 

Things that make you more likely than others to have a stillbirth are called risk factors. Having a risk factor doesn’t mean for sure that you will have stillbirth, but it may increase your chances. Talk to your health care provider about what you can do to help reduce your risk for stillbirth.

You may be more likely than other women to have a stillbirth if you:

  • Are obese. If you’re obese, you have an excess amount of body fat and your body mass index (also called BMI) is 30 or higher. To find out your BMI, go to www.cdc.gov/bmi.
  • Are pregnant with multiples (twins, triplets or more)
  • Are 35 or older
  • Have a medical condition like diabetes or low or high blood pressure. Diabetes is a condition in which your body has too much sugar (called glucose) in the blood. Blood pressure is the force of blood that pushes against the walls of your arteries. Arteries are blood vessels that carry blood away from your heart to other parts of the body. 
  • Have never given birth before
  • Had a miscarriage or stillbirth in a past pregnancy, or you had a baby who died in the first 28 days of life (called neonatal death
  • Had complications in a past pregnancy, like premature birth, preeclampsia or fetal growth restriction. Premature birth is birth that happens before 37 weeks of pregnancy. Preeclampsia is a condition that can happen after the 20th week of pregnancy or right after pregnancy. It’s when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. Fetal growth restriction is when a baby doesn’t gain enough weight in the womb before birth. 
  • Smoke, use street drugs, take prescription painkillers or drink alcohol during pregnancy
  • Are black. Black women have a higher risk for stillbirth compared to other women. American Indian or Alaska Native women and Hispanic women also are more likely to have a stillbirth than white women. Researchers are working to learn more about why stillbirth affects these women more than white women. Differences in access to medical care may be one reason. Getting medical care before pregnancy and going to all your prenatal care checkups during pregnancy may help reduce your risk of having a stillbirth. 

How do you know if your baby is stillborn?

The most common symptom of stillbirth is when you stop feeling your baby moving and kicking. Other signs and symptoms include cramps, pain or bleeding from the vagina. Call your health care provider right away or go to the emergency room if you have any of these conditions. 

Your health care provider uses an ultrasound to see if your baby’s heart has stopped beating. An ultrasound uses sound waves and a computer screen to show a picture of your baby in the womb.  

How are you treated for stillbirth?

If your baby is stillborn, your provider talks with you about options for giving birth. When and how you give birth depends on how far along you are in your pregnancy, your medical history and what you feel is best for you and your family. Some women need to give birth right away for medical reasons, but it’s often safe to wait until you go into labor on your own. Labor usually starts within 2 weeks after a baby dies in the womb. 

Your provider may recommend:  

  • Inducing labor. This is when your provider gives you medicine or breaks your water (amniotic sac) to make your labor begin. Most women choose to have their providers induce labor soon after they learn of their baby’s death. If you don’t go into labor after 2 weeks, your provider may induce labor because there’s a small chance that you can develop dangerous blood clots after this time.
  • Dilation and evacuation (also called D&E). During this surgical procedure, your provider dilates (opens) the cervix to remove your baby from the womb. Having a D&E may limit the information providers can get from doing follow-up tests on your baby.
  • Cesarean birth (also called c-section). This is surgery in which your doctor makes a cut in your belly and uterus to deliver your baby. 

What tests may be done after a stillbirth?

Your provider checks your baby, the placenta and the umbilical cord to try to find out why your baby died. The placenta grows in your uterus and supplies the baby with food and oxygen through the umbilical cord. 

Your health care provider may ask for your permission to do tests on your baby to find out what caused stillbirth. These tests may include:

  • Amniocentesis (also called amnio). In this test, your provider takes some amniotic fluid from around your baby in the uterus. If your provider thinks a genetic condition or an infection in your baby may have caused your stillbirth, she may recommend this test before you give birth.  Genetic conditions are health conditions that are passed from parents to children through genes. 
  • Autopsy. This is a physical exam of a body after death. During an autopsy, a provider checks your baby’s organs for signs of birth defects or other problems.  This may help your provider find out what caused the death and whether you may be at risk of having another stillbirth in the future. 
  • Genetic tests to check for genetic problems in your baby. These tests may check your baby's chromosomes for problems. Chromosomes are the structures that hold genes. Genes are the part of your body's cells that store instructions for the way your body grows and works. 
  • Tests for infections on your baby or on the placenta

In addition to checking your baby for problems, your provider reviews your family health history and any problems or illnesses you had during pregnancy. Your provider may use blood tests or other tests to check you for infections, genetic conditions or other health conditions, like lupus or thyroid problems

Information from tests on you and your baby may help if you’re thinking about getting pregnant again. Test results may help your provider find out if there’s a chance that you could have another stillbirth. Even if your provider doesn’t find out what caused your stillbirth, having the tests may help you better understand and cope with your baby’s death. If you have questions about the tests, including their cost, talk to your health care provider. 

If you’ve had a stillbirth before, can you have a healthy baby in another pregnancy? 

Yes. The chances of having another stillbirth are very low for most women. Less than 1 in 100 women who’ve had a stillbirth in the past (less than 1 percent) go on to have another stillbirth. 

If you had a stillbirth and are thinking about having another baby, give yourself time to heal physically and emotionally. It’s best to wait at least 18 months before you get pregnant again. Talk to your provider about what’s right for you. She may want you to have medical tests to try to find out more about what caused your stillbirth. You may need to wait until after you’ve had these tests to try to get pregnant again.

If you had a stillbirth that was caused by a genetic condition, a genetic counselor can help you understand the chances of having another stillbirth. A genetic counselor is a person who is trained to help you understand about how genes, birth defects and other medical conditions run in families, and how they can affect your health and your baby’s health. Your health care provider can help you find a genetic counselor.

Here are some things you can do help to lower your risk of having a stillbirth in another pregnancy:

  • Get a preconception checkup. This is a medical checkup you get before pregnancy. It helps make sure you’re healthy when you get pregnant. 
  • Get to a healthy weight before getting pregnant. Your provider can recommend ways to get to a weight that’s right for you. 
  • Don’t smoke, drink alcohol, use marijuana or other street drugs or abuse prescription drugs. 
  • If you have any pain or bleeding from the vagina during pregnancy, call your provider right away. 

If you get pregnant again, your provider monitors you and your baby closely. At around 32 weeks of pregnancy, she may ask you to do kick counts to help you keep track of how often your baby moves. Your provider may also do medical tests to check your baby’s heart rate and movements.

What causes stillbirth?

 We don’t know what causes many stillbirths, but common causes include:

Infections in the mother, baby or placenta. Some infections may not cause symptoms in the mother and may not be diagnosed until they cause serious complications, like premature birth or stillbirth. Infections that can cause stillbirth include:

  • Cytomegalovirus. This is a kind of herpesvirus that you can get by coming in contact with body fluid (like saliva, semen, mucus, urine or blood) from a person who carries the virus.
  • Fifth disease. This is a common childhood illness that’s caused by a virus called parvovirus B19. It usually spread through the air from an infected person’s cough or sneeze.
  • Genital and urinary tract infections. These infections affect genitals (also called sex organs), like the vagina or ovaries, or the urinary tract. The urinary tract is the system of organs (like the kidneys and bladder) that helps your body get rid of waste and extra fluids. Getting infected with genital herpes for the first time during pregnancy can lead to stillbirth. Genital herpes is a sexually transmitted disease (also called STD) you can get from having sex with someone who’s infected.
  • Listeriosis. This is a type of food poisoning.
  • Syphilis. This is an STD. 
  • Toxoplasmosis. This is an infection caused by a parasite.

Complications during pregnancy, including:

  • Being pregnant longer than 42 weeks
  • Diabetes
  • High blood pressure 
  • Lupus. This is an autoimmune disorder. Autoimmune disorders are health conditions that happen when antibodies (cells in the body that fight off infections) attack healthy tissue just about anywhere in the body by mistake.
  • Obesity
  • Preeclampsia
  • Preterm labor. This is labor that begins early, before 37 weeks of pregnancy.
  • Preterm premature rupture of the membranes (also called PPROM). This is when the sac around the baby breaks early, causing labor to start. 
  • Trauma or injuries (like a car accident)
  • Thrombophilias. These are health conditions that increase your chances of making abnormal blood clots.
  • Thyroid disorders. These are conditions that affect your thyroid, a gland in your neck that makes hormones that help your body store and use energy from food.

Conditions in the baby, including: 

  • Birth defects and genetic conditions. About 14 in 100 stillborn babies (14 percent) have one or more birth defects, including genetic conditions like Down syndrome.
  • Fetal growth restriction 
  • Not getting enough oxygen during labor and birth
  • Rh disease. Rh factor is a protein on the surface of red blood cells. Rh disease happens when a woman who doesn’t have the protein (called Rh-negative) is pregnant with a baby who does have the protein (called Rh-positive). 

Problems with the placenta. These can include blood clots, inflammation (redness, pain and swelling), problems with blood vessels in the placenta and other conditions, like placental abruption. Placental abruption is a serious condition in which the placenta separates from the wall of the uterus before birth. Women who smoke cigarettes or use cocaine during pregnancy are more likely to have placental abruption than other women. Placental problems cause about 24 in 100 stillbirths (24 percent).

Problems with the umbilical cord, like having a knot in the umbilical cord. Accidents involving the umbilical cord may lead to about 10 in 100 stillbirths (10 percent). 

How can you deal with feelings of grief after a stillbirth?

Grief is all the feelings you have when someone close to you dies. Having a stillborn baby is a painful loss for a family. But there are things you can do to help you grieve, heal and remember your baby

After birth, do what feels right for you and your family. You may want to spend time alone with your baby and other family members. You can name your baby, hold your baby and take part in cultural or religious traditions, like baptism. Some families take photos of their baby, make footprints or save locks of hair because these keepsakes help them remember their baby. 

Parents who have a stillbirth need time to grieve. You and your partner may cope with grief in different ways. This may cause problems for the two of you. You also may need help dealing with others as you grieve. Ask your health care provider to help you find a counselor who can help you cope with your baby’s death. 

Having a stillbirth may make you more likely to have postpartum depression (also called PPD). PPD is a kind of depression that some women get after having a baby. Tell your health care provider if you think you may have signs of PPD. 

Talking about your feelings may help you deal with your grief. Visit Share Your Story®, our online community where families who have lost a baby can talk to and comfort each other. Sharing your story may ease your pain and help you heal. Our resources for grieving families can help you deal with your loss, including the booklet From Hurt to Healing.

See also: From hurt to healing, Remembering your baby, Dealing with the unexpected, Dealing with your grief, Dealing with others as your grieve

More information

Share Your Story®
Stillbirth Collaborative Research Network
First Candle
International Stillbirth Alliance
Star Legacy Foundation

Last reviewed June 2015

Have questions?

Frequently Asked Questions

How do you know if you’re having a miscarriage?

Signs of a miscarriage can include vaginal spotting or bleeding, abdominal pain or cramping, and fluid or tissue passing from the vagina. Although vaginal bleeding is a common symptom of miscarriage, many women have spotting early in their pregnancy but don’t miscarry. But if you’re pregnant and have bleeding or spotting, contact your health care provider right away.

 

What is dilation and curettage?

Dilation and curettage (also called D&C) is when a doctor removes tissue from the lining of a woman's uterus. Dilation ("D") is a widening of the cervix to allow medical instruments into the uterus.  Curettage ("C") is the scraping of the walls of the uterus.

Some women have a D&C after a miscarriage to remove tissue. Providers also use D&C to treat heavy bleeding or to help diagnose infection, cancer and other diseases.

After  a D&C, you can return to your regular activities as soon as you feel better, maybe even the same day. You may have vaginal bleeding, pelvic cramps and back pain for a few days after the procedure. Talk to your provider about medicine you can take for pain. Don’t use tampons or have sex for 1 to 2 weeks after the procedure.

When can I try to get pregnant again?

For most women, it's best to wait at least 18 months before getting pregnant again. This amount of time is best if you miscarry, or if your baby is stillborn, or if your baby dies after birth. Waiting this long gives your body enough time to heal between pregnancies. Also, giving yourself this time may help you feel less worried about your next pregnancy. Depending on your age or other medical reasons, you may not be able to wait this long. Talk to your provider about what's right for you.

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