Expectant women at a clinic. One should seek a doctor’s intervention in case there is no foetal movement .
Dr Joan Okemo, a consultant obstetrician gynaecologist at the Aga Khan University Hospital, says stillbirth is the heartbreaking loss of a baby after 24 weeks of pregnancy. She says, sometimes, doctors may identify the cause of the occurrence but reasons mostly remain unknown.
Dr Okemo (pictured) says that even though there is no known cause of stillbirth, possible causes could include placental abruption (where the placenta separates from the uterus) or poor placental function, and health issues with the baby.
The problems with the baby could include developmental problems or infections that interfere with growth and well-being. Others are maternal health conditions such as poorly controlled diabetes, high blood pressure or bleeding before baby is born, which can increase the risk of stillbirth.
“Lifestyle choices and medical intervention
are some of the risk factors to stillbirths,” Dr Okemo says.
She continues: “Some of the unchangeable risk factors include being very young (under 20) or older (over 35), a history of stillbirth or pregnancy complications, like preeclampsia, carrying multiples (such as twins), carrying a baby beyond 41 weeks, having a smaller baby (known as Fetal Growth Restriction), low education levels, reduced fetal movement, underlying health conditions such as thyroid issues, blood clotting disorders, or infections.
Changeable risk factors can include high blood pressure or obesity, smoking more than 10 cigarettes a day, drinking alcohol or using drugs and living in areas with limited healthcare access or higher levels of deprivation, Dr Okemo explains.
She says that the most noticeable sign of a stillbirth is a lack of fetal movement and advises pregnant women to seek a doctor’s intervention in case they experience it. The doctors will then perform an ultrasound to determine if stillbirth has occurred. She says that ultrasound is the most accurate way to detect if a stillbirth has occurred.
“After the diagnosis is confirmed, the family should be given time to process. While privacy is important, they should not be left to feel isolated and healthcare providers should be available to respond to any concerns they might have including birth plans, pain relief options, and ways to make memories with the baby.
If needed, extra time before proceeding
with labour can be granted - typically up to 48 hours - unless medical concerns
require quicker intervention. For those who experience health risks like heavy
bleeding or high blood pressure, doctors may recommend expedited delivery to
avoid further complications.
“Labour is typically induced using medication to start contractions, though some women may choose to wait for labour to begin naturally. In certain cases, a Cesarean section may be needed, depending on the situation. Counseling and access to mental health resources to help the family navigate the tragic moment should be given.” Dr Okemo asserts.
She says that after delivery, one may experience bleeding, cramping, and fatigue, similar to what you would experience after any birth.
However, if you notice heavy bleeding, fever, or any other signs of infection, it's vital to seek immediate medical attention.
In addition to physical recovery, emotional health must be carefully monitored. Many women may face postpartum depression (PPD), which can manifest as sadness, trouble bonding with other children, excessive crying, or difficulty sleeping.
“If you're struggling, seeking support from
a counselor or mental health professional is essential.”
After a stillbirth, it is crucial for the mother to take steps to care for her health, especially if one is planning another pregnancy.
“Your healthcare team should closely monitor factors like blood pressure, thyroid function, and other conditions that could impact future pregnancies. This ensures that any potential risks are identified early,” she says.
Dr Okemo advises women to wait at least six months after a stillbirth before trying to conceive again. This allows the body time to heal physically and emotionally, while also reducing the risk of complications such as preterm birth or low birth weight.
