"Stillbirth" refers to fetal death after 20 weeks' gestation. It occurs in one in two hundred pregnancies and often involves apparently healthy fetuses. The most common known causes of stillbirth are maternal diabetes, bacterial infection, high blood pressure, placental problems, growth restriction, and umbilical cord accidents. But in over half of stillbirths, a cause cannot be determined even after extensive testing.
Most fetal deaths are detected before labor begins, usually at a routine prenatal check, or when a woman notices an absence of the usual kicks and movement. An ultrasound and fetal heart monitor will confirm that the baby has died. If there is no medical need for immediate delivery, you will be able to decide whether to wait for labor to come naturally or to have labor induced. Having the chance to prepare yourself for the experience may help you manage the physical and emotional pain.
Once the baby is born, you will need to decide whether you want to see and hold her or him. You may want to name the baby if you haven't already done so, take photos, and take some time to say your goodbyes. It may seem at first that seeing or holding the baby will be too much to handle, but many women later feel grateful that we did this. Such acts help to acknowledge the infant's existence and to preserve her or his memory. Some hospitals now offer a "memory box" to bereaved parents; it can include footprints and handprints, along with any items that were in contact with the baby, such as a blanket.
You will be faced with a number of difficult and pressing decisions, including how you wish the baby's remains to be handled and whether you want to have an autopsy performed. The thought of an autopsy can be painful, and in many cases there is no conclusive answer. Yet an autopsy could provide important information about the cause of the stillbirth, which may help with closure and provide information for future pregnancies. If you choose to have an autopsy done, the person performing it should be a pediatric or neonatal pathologist, or working with one. If the person is not, you may want to ask for a referral to a pathologist with the necessary expertise to review the findings.
More Answers from Boston Women's Health Book Collective