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Stillbirth and neonatal death

stillbirth; still; birth; death; neonatal; intrapartum; SANDS;

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It is very uncommon for a baby to die in late pregnancy these days because women are healthier and good antenatal care is available. However, unfortunately some babies do die, sometimes without warning and despite women doing all the right things.

Some babies die in the uterus (womb) before they are born (called an intra-uterine fetal death). It can happen during the last half of pregnancy or, more rarely, during the labour and birth, when it is known as intrapartum death. When the baby is born this is called a stillbirth. If a baby is born alive, but dies in the first 4 weeks of life, this is called a neonatal death.

In South Australia, these deaths happen in less than 1 per cent of babies.

What causes stillbirth?

Some of the known causes include:

  • Abnormality of the baby
  • Infection
  • Problems with the placenta - placenta praevia or bleeding from the placenta
  • Poor growth

Sometimes the cause cannot be found, even on autopsy.

What happens if your baby dies before birth?

The death of a baby can be confirmed by ultrasound examination.

Your doctor will discuss the options of waiting till labour starts spontaneously or inducing labour with prostaglandin gel or a hormone drip. The plan for the birth, including methods of pain relief and your choice of support persons, will also be discussed. Your doctor may be able to describe the expected size and appearance of your baby.

If your baby dies before, during or soon after birth, he or she can stay with you for you to hold, love and dress if this is what you would like to do. You may not feel that you want to do this at first, but you usually will have some time to change your mind if you want to.

You will need to name your baby. Later on it will help when you can remember your baby by his or her name. Some parents may choose to bless or baptise their baby. The hospital will take photos for you and help you to arrange a funeral. Most hospitals will have social workers who can help.

Your doctor will probably suggest that an autopsy (post mortem examination) be done to work out why your baby died. In South Australia, if a baby dies after birth and the cause of death is not known, the law requires a post mortem be done. Afterwards, your doctor will talk to you about the results.

What happens to you after the birth?

After a stillbirth or neonatal death, you will still need to recover from the birth.

  • You will lose blood through your vagina (like a heavy menstrual period).
  • Your breasts will still produce milk, which can be uncomfortable. Pain relief medication such as paracetamol, a well fitting bra and cold packs may help. After a few days, your breasts will become less full, but you may still have some milk in your breasts for a long time.

If you are well, you can go home from hospital soon after the birth. The hospital will usually arrange for someone to visit you in the next couple of days. Your doctor will organise a check-up for you within a few weeks.

There are several other topics which may help you care for your body after the birth. They do contain information about caring for a baby, but the other information is important for you as your body has experienced a lot of changes during your pregnancy and the birth of your baby.

Help for grieving parents and families

The death of a baby is always a tragedy. It will be painful for both the parents and for other family and friends.

The loss of your pregnancy at any stage can have a big impact on you and your partner. One day you are pregnant and planning your future life with your child, and then within a short time, your pregnancy ends, and your dreams and plans are gone.

The feelings can be very intense:

  • Sadness
  • Anger
  • Irritability
  • Crying
  • Difficulty sleeping
  • Dreams/nightmares
  • Disbelief
  • Guilt
  • Confusion
  • Isolation
  • Not wanting to be alone
  • Not wanting to see anyone
  • Wanting to talk.

These feelings can be very intense. It is important to remember that they will reduce with time. It is also important to remember that your own experience is unique and you have the right to recover in your own way and in your own time.

You will need recuperation time, especially to recover emotionally. Try to reduce challenges as much as possible and allow yourself time to be with people with whom you are comfortable. Give yourself as much time as you need to recover.

Whatever your feelings, allow yourself time to grieve, to cry, and to talk about the emotions you feel. Do not expect too much of yourself.

  • It can be a big help to find someone you can talk to who will listen and understand.
  • You may benefit from contacting a support group (such as SANDS) and talking to other parents who have had a similar experience.

Your partner will also experience a wide range of feelings and may be unsure how to comfort and help you. His feelings about the loss are different from yours. You may each grieve in different ways and it is important to talk to each other and to be aware of each other’s feelings.

The doctors and midwives will support you emotionally by giving you and your family information, answering your questions and listening to your concerns and feelings. Most hospitals also have social workers who you may want to talk to.

Recovery from a loss like this can take a very long time, and some women still feel sadness at special times each year for many years.

Resources in South Australia 

SANDS

SANDS (SA) is a support group in South Australia for parents and their family whose baby has died through stillbirth, neonatal death, miscarriage, ectopic pregnancy and medically advised termination.
Phone 1300 072 637 (24 hours)

The SANDS website has information for bereaved parents and also for their relatives and friends. There is a book list and some stories written by bereaved parents.
SANDS South Australia

SANDS can be contacted 24 hours a day.

There are SANDS groups in some other Australian states and information can be obtained from the SANDS Australia website 
http://www.sands.org.au

Pregnancy Loss Australia  

Pregnancy and Infant Loss Support  for bereaved parents who suffer the loss of their baby or babies due to miscarriage, still birth, termination of pregnancy for foetal abnormality, and neonatal death. (Australia)
http://pregnancylossaustralia.org.au/

Pregnancy Loss Australia has published a book 'You are not alone' which is available via their website.

Grieflink

The Grieflink site has some information about grieving for the loss of a stillborn or newborn baby. 
http://grieflink.org.au/ 

 

More information and videos

Raising Children Network 

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see your doctor or midwife.

 

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