Stillbirth

A baby who dies before or during birth after 24 weeks. Around eight families a day in the UK, and reduced movements is the sign to act on.

What it is

The death of a baby before or during birth, from 24 completed weeks of pregnancy. Around one in every 250 births in the UK, which is roughly eight families a day.

Rates have fallen but remain higher than in comparable countries, and they are markedly higher for Black and Asian families and in the most deprived areas. That inequality is well documented and is not explained by biology alone.

Some causes are identifiable: placental problems, pre-eclampsia, infection including group B strep, diabetes, growth restriction, and cord accidents. In a substantial proportion no cause is found, which families find extremely hard.

Several things reduce risk and are worth acting on: going to sleep on the side after 28 weeks rather than on the back, stopping smoking, attending all antenatal appointments, and above all reporting reduced or changed fetal movements immediately.

**There is no such thing as a baby running out of room to move.** That belief is common, it is wrong, and it costs babies' lives. Movements should not reduce towards the end of pregnancy.

After a stillbirth, a post-mortem and placental examination are offered. Many families decline in the moment and regret it later; it is worth taking time over.

Signs you might notice

Reduced, absent or changed fetal movements. Contact the maternity unit immediately, at any hour. Do not wait until morning, do not use a home doppler, and do not drink cold water and lie down first.

Vaginal bleeding, abdominal pain, or leaking fluid.

Severe headache, visual changes, or sudden swelling, which may be pre-eclampsia.

Itching, particularly of the hands and feet, which may be obstetric cholestasis.

Feeling that something is wrong. Maternity triage would far rather see somebody unnecessarily.

How it can affect day-to-day life

The care in the days afterwards shapes the grief for years. Time with the baby, photographs, hand and footprints, naming, and a memory box all matter, and families should be offered them rather than having to ask.

Grief after stillbirth is often unwitnessed. Colleagues and acquaintances did not meet the baby, and many say nothing at all, which compounds the isolation. Saying the baby's name is one of the kindest things available.

Partners grieve and are consistently overlooked, including at work.

Practical realities arrive immediately and cruelly: milk coming in, registering the death, arranging a funeral, and undoing the preparations at home.

Parents have legal entitlements including maternity leave and parental bereavement leave, and are frequently not told.

A subsequent pregnancy is lived with an anxiety that is impossible to describe; specialist rainbow clinics and extra scanning exist and should be asked for.

Supporting someone well

Report reduced movements immediately, every time. Never be reassured by a home doppler.

Sleep on the side from 28 weeks.

Afterwards, take time over decisions about seeing and holding the baby, photographs and post-mortem. Families rarely regret doing these things and often regret not.

Say the baby's name. Ask about them. Do not avoid the subject to protect yourself.

Do not say at least you can have another, everything happens for a reason, or that they are in a better place.

Ask the partner how they are, more than once.

Ask about bereavement midwives, and about a named contact for the results appointment.

In a later pregnancy, ask for referral to a specialist clinic with extra monitoring.

Where to get help

Maternity triage immediately for reduced movements, at any hour.

The hospital bereavement midwife, and the GP practice, which should be told before the family is contacted about routine appointments.

Sands run a free helpline on 0808 164 3332 and are the specialist stillbirth and neonatal death charity.

Tommy's midwives on 0800 014 7800, including for pregnancy after loss.

Cruse Bereavement Support for wider grief support.