A stillborn baby is a baby who is born dead after 24 completed weeks of pregnancy. If the baby dies before 24 completed weeks, it is known as a late miscarriage.

Stillbirth is much more common than many people think. There are around 4,000 stillbirths every year in the UK and one in every 200 births ends in a stillbirth. Eleven babies are stillborn every day in the UK, making stillbirth 10 times more common than cot death.

What causes stillbirth?

In almost half of stillbirths, the direct cause of the baby's death cannot be established, although it is possible to identify any conditions associated with the death through a post-mortem. Read more about what happens after a stillbirth.

Ten percent of stillborn babies have some kind of abnormality. Other possible causes of stillbirth include problems with the mother's health or problems with the placenta (the afterbirth that links the baby’s blood supply to the mother’s). Read more about causes of stillbirth.

Help and support

Stillbirth and late miscarriage can be devastating for the parents of the baby and it can also affect their relatives and friends.

Counselling should be offered after a stillbirth and may help parents to cope with their grief, anxiety and other feelings.

There are many support groups in the UK for bereaved parents and their families. Our directory can help you find bereavement support services in your area. These support groups are usually run by parents who have experienced stillbirth or by healthcare professionals, such as baby loss support workers or specialist midwives.

(See getting help for people affected by stillbirth for more information).

Due to lack of research, 30% of stillbirths remain unexplained. However, some conditions that can cause stillbirth or may be associated with stillbirth include:

• bleeding (haemorrhage): before or during labour
• problems with the placenta (afterbirth): which can separate from the womb before the baby is born (placental abruption), or the placenta can fail to provide the baby with enough oxygen and nutrients which means that the baby does not grow properly (intra-uterine growth restriction is associated with one-third of all stillbirths)
• a problem with the umbilical cord: which attaches the placenta to your baby’s tummy button; it can slip down through the entrance of the womb before the baby is born (known as cord prolapse and it occurs in about 1 in 200 births), or it can wrap around the baby’s neck
• pre-eclampsia: a condition that can cause high blood pressure in the mother; mild pre-eclampsia can affect up to 10% of first time pregnancies and more severe pre-eclampsia can affect 1-2% of pregnancies
• a genetic physical defect in the baby
• a liver disorder in the mother called obstetric cholestasis which occurs in 1 in 200 pregnancies; see the Royal College of Obstetricians and Gynaecologists (RCOG) website for more information about obstetric cholestasis
• diabetes in the mother
• infection in the mother that also affects the baby (see below)

Infections

About 7% of stillbirths are caused by an infection. The infection can either ascend from the vagina into the womb (uterus) or it can be passed from the mother to the baby through the placenta.

Infections that can cause stillbirth include:

• coxsackie virus: which can cause hand, foot and mouth disease in humans
• cytomegalovirus: a common virus from the herpes family of viruses that often causes few symptoms in the mother
• herpes simplex: the virus that causes 
• leptospirosis: a bacterial infection that is caught from animals such as cows, pigs, dogs and rats
• listeriosis: an infection that usually develops after eating food that has been contaminated by bacteria called Listeria monocytogenes (listeria); it may cause vomiting and diarrhoea in the mother (see preventing stillbirth for more information about the foods to avoid during pregnancy)
• Lyme disease: a bacterial infection that is spread by infected ticks
• malaria: a tropical disease that is spread by mosquitoes
• parvovirus B19: which causes slapped cheek syndrome, a common childhood  infection
• Q fever: a bacterial infection caught from animals such as sheep, goats and cows
• rubella (German measles): this is rare because most pregnant women have had the MMR vaccine to protect against rubella
• flu: it is recommended that all pregnant women have the seasonal flu vaccine irrespective of their stage of pregnancy
• toxoplasmosis: an infection caused by a parasite that is found in soil and cat faeces 

Increased risk

There are a number of factors that increase your risk of having a stillborn baby. They are:

• having twins or a multiple pregnancy - see risks in multiple pregnancy for more information
• being younger than 20 years of age
• being over 35 years of age
• having diabetes, high blood pressure or a blood-clotting disorder
• being a smoker: see why should I stop smoking if I’m pregnant?
• being obese: having a body mass index (BMI) of over 30

Most stillbirths happen before labour starts and can usually be detected with an ultrasound scan. An ultrasound scan uses high-frequency sound waves to create an image of your baby, which will show whether or not your baby’s heart is beating.  

If your baby’s heartbeat cannot be found, a doctor will usually be asked for a second opinion. There may also be other signs to suggest that your baby has died.

Sometimes, after the baby’s death has been confirmed, a mother may still feel her baby moving. This is called passive foetal movement and can happen when the mother changes position. Sadly, it does not mean that the baby is still alive.

Finding out that your baby has died is devastating. The healthcare professionals who are with you should offer you support and explain your options to you (see getting help after a stillbirth).

Induced labour

If a baby dies before labour starts, labour is nearly always induced (started by using medication). This is because labour is safer for the mother than having a caesarean section (see below).

It may sometimes be necessary to induce labour immediately. This is usually the case if the:

• mother has severe onset pre-eclampsia: a problem with the placenta
• mother has a life-threatening infection: which makes her immune system (the body’s natural defence against infection and illness) overreact, causing blood clotting and widespread inflammation
• the bag of waters around the baby (the amniotic sac) has broken

If the mother is otherwise healthy, labour can be delayed for a little while if that is what the mother prefers.

The labour is induced by inserting a pessary (tablet), or gel, into the vagina, or by swallowing a tablet. Sometimes, medication is given through a drip into the mother’s arm. About 9 out of 10 women will give birth within 24 hours.

Caesarean

In a very few cases, a caesarean section will be necessary. A caesarean is a surgical procedure where the baby is delivered through a cut in the mother’s abdomen. The cut is usually made just below the bikini line.

After a stillbirth, many parents want to see and hold their baby. This is entirely up to you. You will be given some quiet time with your baby if this is what you want.

You can take photographs of your baby and keep mementos, such as a lock of hair, foot prints or hand prints, or the blanket that your baby was wrapped in at birth. You may also want to name your baby. However, not everyone does and again, it is up to you.

Counselling

You may be offered some bereavement counselling, which can be a great source of support. See getting help after a stillbirth for more information.

You may be introduced to a bereavement support officer or a bereavement midwife. They usually work in hospitals or as part of the local council. They can help you with any paperwork that needs to be completed and explain the choices you can make about your baby’s funeral. They will also be able to act as a point of contact for other healthcare professionals.

Finding the cause

The baby's mother may be offered some tests that might find the cause of the stillbirth. These include:

• blood tests: which may show that the mother has pre-eclampsia (a problem with the placenta) or, rarely, diabetes
• testing for infections: a sample of urine, blood or cells from the vagina or cervix (the neck of the womb) can be tested
• thyroid function test: to see whether the mother has a condition that affects her thyroid gland

There are also tests that can be carried out on your baby to try to establish the cause of death or any conditions that might have contributed to your baby’s death.

Post-mortem

A post-mortem is an examination of your baby’s body and is undertaken by a specialist doctor called a perinatal pathologist. The examination can provide more information about why your baby died, which may be particularly important if you plan to become pregnant in the future.

A post-mortem cannot go ahead without your written consent and you will be asked if you want your baby to have one. The procedure can involve a number of tests, such as examining your baby’s organs in detail, looking at blood and tissue samples and carrying out diagnostic genetic testing to see whether your baby has a genetic disease.

The healthcare professional who asks for your consent will explain the different options so that you can decide whether you want your baby to have a post-mortem and, if you do, which tests you want the perinatal pathologist to carry out.
 
Read more about post-mortems.

Registering a stillbirth

By law, all babies who are stillborn after 24 completed weeks of pregnancy must be registered. Registering a stillbirth gives the parents an opportunity to acknowledge their baby’s birth. It is also important for statistical records.

Stillbirths must usually be registered within 42 days and they cannot be registered more than three months after the birth. Once the stillbirth has been registered you cannot change your baby’s name (if you decide to name them).

See the DirectGov website about registering or changing a stillbirth record and how to get help with it.

A third of stillbirths remain unexplained - that is, the babies appear to be perfectly healthy. Scientists still do not know why these babies die and more research is needed. 
 
There are some things that you can do to improve your health and reduce your risk of having a stillborn baby. These include:

• stopping smoking (if you smoke): smoking increases the risk of stillbirth
• avoiding drinking alcohol while pregnant: alcohol can seriously affect your baby’s development and increases the risk of miscarriage during the first three months
• avoiding recreational drugs: illegal drugs, such as cannabis, cocaine, ecstasy and heroin, can harm your baby
• monitoring your baby's movements (see below)
• reporting any tummy pain or vaginal bleeding that you have
• protecting yourself against infections (see the causes of stillbirth) and avoiding certain foods (see below)
• attending all your antenatal appointments

Your weight

Obesity (a body mass index of over 30) is a risk factor for stillbirth. You can check your BMI using the healthy weight calculator. However, if you're pregnant the calculator may not be accurate so you should consult your midwife or doctor instead. 

The best way to protect your health and your baby’s wellbeing is to lose weight before you become pregnant. By reaching a healthy weight, you cut your risk of all the problems that are associated with obesity in pregnancy. Contact your GP for advice about how to lose weight. They may be able to refer you to a specialist weightloss clinic.

If you're obese when you become pregnant, you should discuss with your midwife or GP how much weight you expect to gain during the pregnancy .

Eating healthily and activities such as walking and swimming are good for all pregnant women. If you were not active before becoming pregnant, you should consult your midwife or doctor before starting a new exercise programme while you're pregnant.

Read more about what to do if you are overweight and exercises and keeping active during pregnancy.

Monitoring your baby's movements

You will usually start feeling some movement between weeks 16 and 22 of your pregnancy. Every baby has its own pattern of movements and around this stage of your pregnancy you will start to get to know your baby’s movements.

At each antenatal appointment, your midwife will talk to you about the pattern of movements. A change, particularly a reduction in movements, may be a warning sign that your baby needs further monitoring.

After week 28 of your pregnancy, you should contact your GP or midwife immediately if, compared to normal movements for your baby, you notice that:

• there has been a continuous decrease in movements over several days
• there is a big decrease in your baby’s movements
• your baby has stopped moving completely

The website of the national charity, Sands (stillbirth and neonatal death), has more information and advice about getting to know your baby’s movements and what to do if you think there is a problem.

Avoiding certain foods

There are some foods that you should not eat during pregnancy and some extra precautions that you should take for you and your baby's wellbeing.

For example, you should not eat some types of fish or cheese, and you should make sure that all meat and poultry is cooked thoroughly.

Read more about the foods to avoid during pregnancy.

Attending antenatal appointments

During your antenatal appointments, your midwife or GP will monitor the development of your baby. They will monitor your baby’s growth and position.

You will also be offered a series of tests to detect any illnesses or conditions, such as pre-eclampsia (problems with the placenta), that may cause complications for you or your baby. Any necessary treatment can be provided promptly and efficiently.

Read more about antenatal care.

A stillbirth can be emotionally traumatic for both the mother and father. Some parents may experience feelings of guilt or anxiety following the loss of their baby.

After a stillbirth, you may be offered counselling. This gives you an opportunity to talk to a trained professional about what you are going through

 A counsellor is trained to listen sympathetically and they will be able to help you find ways of coping with your grief. Many hospitals and most GPs can refer parents for counselling following the death of their baby.

Sometimes, a stillbirth can have a prolonged emotional effect on parents and families, so counselling may be helpful. Counsellors may also be able to provide you with advice and guidance about how to explain the stillbirth to other children you may have and how to help them grieve.

Some parents become very depressed or experience post-traumatic stress disorder following the loss of a baby. These conditions can be treated and you should seek the support and advice of your GP.

Read more about depression and post-traumatic stress disorder.

Support groups

Support groups can also help if you have had a stillbirth.

Sands (the stillbirth and neonatal death charity) provides support for anyone who is affected by the death of a baby. The charity runs a helpline and funds research into the causes of stillbirth.

You can call the confidential helpline on 020 7436 5881, or you can email them confidentially (helpline@uk-sands.org). The helpline is open from 9.30am to 5.30pm, Monday to Friday. It is also open later on Tuesday and Thursday evenings, from 6pm to 10pm.

There are many other self-help groups in the UK for bereaved parents and their families. You can use the find services directory to find bereavement support services in your area. These support groups are usually run by parents who have experienced stillbirth or by healthcare professionals, such as baby loss support workers or specialist midwives.

Special memories packs, memorial gardens, remembrance services and books of dedication are all possible ways of honouring stillborn babies. See the Live Well section for more information about dealing with loss.