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A. It is not always possible to give an answer but a cause is found about 50% of the time.
A baby dying before birth occurs in one in every 200 pregnancies.
The most common reason for a baby dying in the womb is because the baby has not been growing properly. There are other causes, including infection, abnormal development of the baby, diabetes, early separation of the placenta and pre-eclampsia.
You and your partner will be offered tests to try to find out why your baby died.
A. Death of a baby in the womb is confirmed by an ultrasound scan. The scan is able to show if your baby’s heart has stopped beating. If you wish, you can ask for another scan to reconfirm your baby’s death.
Sometimes, after it has been confirmed that your baby has died, you may still feel as if your baby is moving. This is caused by the shifting movements of your baby within the fluid in your womb and can be very distressing. Your doctor will be able to talk to you about this.
A. The doctor will talk to you and your partner about the death of your baby and explain your choices for birth, and the various tests that may be offered.
You and your partner will be given support and plenty of time to make any decisions you need to make.
You will be seen by a doctor to make sure that you are well yourself. This includes, for example, checking for infection and pre-eclampsia.
A. Your doctor will discuss with you and your partner the different options of when and how to have your baby. The advice will depend on your general health, your pregnancy and any previous birth experiences, and also your personal wishes.
Inducing labour (starting labour with medication)
You may choose to have labour induced as soon as possible after confirmation of your baby’s death, or you may prefer to go home for a short while before treatment. Some women find it comforting to spend some time at home. There are different ways of inducing labour and your doctor will discuss with you which method would be the most appropriate for you. Often, a tablet is given by mouth 48 hours before admission for induction.
Letting nature take its course
You may choose to wait at home for labour to start naturally. If your waters have not broken and you are well physically, you are unlikely to come to any harm if you delay labour for a short period of time (up to 48 hours). Most women will go into labour naturally within 3 weeks of their baby dying in the womb.
You need to be aware that delaying the onset of labour will affect the appearance of your baby at birth. In addition, tests that you agree to being carried out on your baby may give less information. If you decide to wait for more than 48 hours, you will be advised to have a check-up at the hospital twice a week as a small number of women will become unwell during this time.
You may be advised against delaying labour if you have pre-eclampsia or an infection, or if some of the blood tests show that a delay would put your health at risk.
You may decide that it would cause you greater anxiety to delay starting labour than having your labour induced (when labour is started with medication).
A. Vaginal birth is usually recommended. Although you may find the thought of a vaginal birth distressing, you may want to consider that:
Your doctor will discuss your choices with you and your wishes will be respected. All types of pain relief will usually be available in labour.
An epidural may not be possible if you have an infection or problems with blood clotting but all steps will be taken to ensure that you get the pain relief you need.
A. If you have had one previous caesarean section, it is usually safe to have labour induced although it is not completely without risk. A vaginal birth not only has the advantages stated above but having a repeat caesarean section has additional risks and makes a future vaginal delivery less likely.
A. You will be given additional support by the doctors looking after you, who know that giving birth is going to be a distressing experience for you and your family.
A. You can usually go home when you wish, although if you have been unwell you may be advised to stay in the maternity unit for a little longer. Some women and partners want to go home as soon as possible, whereas others prefer to stay for a while.
After the birth of your baby you may experience the sensation of breast milk coming into your breasts, making them feel full and uncomfortable. Ice packs, breast support and pain relief may help but, despite this, one in three women may still experience excessive discomfort. In this instance, there are tablets available that will stop your body producing milk and relieve your symptoms at this distressing time. The doctor can prescribe these tablets if you need them.
As with any birth, you will have bleeding and pain for a few days. This should settle down within a week.
Problems are uncommon after birth but you should contact your doctor if:
A. You will be offered tests for you and your baby that may help to find out why your baby has died. A cause is found in about 50% of cases and this can help with planning your care in a future pregnancy. Unfortunately, despite tests, sometimes deaths cannot be explained.
You and your partner will be given time to think about which tests you would like to have done and you will be supported in any choices you make. You will need to sign a consent form for some of the tests. You will be offered an appointment at a later date to discuss the results of any tests that you have consented to being done.
Tests you and your partner will be offered include:
A. Follow-up appointment with your obstetrician will be arranged to discuss the results of the tests.
A. If you decide to have another baby, you will will be seen early in your pregnancy.
You will usually have extra antenatal visits as you will understandably be anxious.
You will be given additional support by the doctors looking after you throughout your pregnancy.
The precise pattern of your care will be influenced by the results of any tests and whether a cause has been found for the death of your baby.