Stillbirth: Causes, Risk Factors, Grief, and Future Pregnancy

Possible causes include:

• placental problems;
• fetal growth problems;
• chromosome or genetic conditions;
• maternal medical conditions;
• infections;
• umbilical-cord complications;
• pregnancy complications.

Sometimes, even after medical investigation, no definite cause is found.

• still, historically referring to the absence of life or movement;
• birth, the process of being born.

Examples include:

• She experienced a stillbirth at 34 weeks.
• The hospital investigated the cause of the stillbirth.
• Their baby was stillborn.

The adjective stillborn refers to a baby born without signs of life:

• a stillborn baby;
• their child was stillborn.

Common expressions include:

• stillbirth risk;
• stillbirth prevention;
• stillbirth investigation;
• pregnancy after stillbirth;
• unexplained stillbirth;
• late stillbirth.

Miscarriage generally refers to loss earlier in pregnancy.

Stillbirth refers to fetal death later in pregnancy, after a threshold set by the relevant healthcare system.

Because the definitions differ internationally, a pregnancy loss at the same gestational age might be classified differently in different countries.

The emotional significance of a loss is not determined by the medical label or gestational age.

Possible causes or contributing factors include:

• placental insufficiency;
• placental abruption;
• fetal growth restriction;
• congenital abnormalities;
• chromosome conditions;
• maternal hypertension;
• preeclampsia;
• diabetes;
• infection;
• umbilical-cord complications;
• severe fetal anemia;
• pregnancy extending well beyond the expected due date.

In some cases, several factors may interact.

In others, no cause is identified despite thorough investigation.

If placental function becomes impaired, the fetus may receive inadequate oxygen or nutrition.

Placental problems associated with stillbirth may include:

• placental insufficiency;
• placental abruption;
• blood-flow abnormalities;
• inflammation;
• abnormal placental development.

Placental examination after a stillbirth may provide important information about possible causes.

It may occur because of:

• placental dysfunction;
• maternal medical conditions;
• genetic conditions;
• infection;
• other pregnancy complications.

A fetus that is significantly growth-restricted may face increased risk of serious complications, including stillbirth.

Pregnancy monitoring may include ultrasound measurements, blood-flow studies, and assessment of fetal well-being.

These may include:

• chronic hypertension;
• preeclampsia;
• diabetes;
• kidney disease;
• autoimmune disorders;
• some blood-clotting conditions;
• severe obesity;
• certain infections.

Good prenatal care and management of underlying conditions can reduce some risks, although stillbirth cannot always be prevented.

Potentially relevant infections vary by region and pregnancy circumstances.

Infection may contribute to:

• premature rupture of membranes;
• inflammation of placental tissues;
• fetal infection;
• maternal illness.

Not every infection during pregnancy causes fetal harm.

Testing may be performed when symptoms, placental findings, or other evidence suggest infection.

Certain cord problems may contribute to fetal compromise.

Examples include:

• cord compression;
• true knots;
• cord prolapse;
• abnormal cord insertion;
• severe blood-flow interruption.

However, cord loops around the neck are common and usually do not cause stillbirth by themselves.

A cord finding should therefore be interpreted carefully rather than automatically assumed to be the cause.

A pregnant person who notices:

• much less movement than usual;
• no movement;
• a clear change in the baby’s normal movement pattern

should contact a maternity-care provider promptly.

There is no single movement count that fits every pregnancy, because fetal movement patterns differ.

The important point is recognizing a significant change from what is normal for that pregnancy.

Diagnosis usually involves:

• ultrasound;
• confirmation that fetal cardiac activity is absent;
• examination by a qualified clinician.

After confirmation, the healthcare team discusses delivery options, medical care, and emotional support.

Some people may already have symptoms such as bleeding, pain, contractions, or reduced movement, while others may have no obvious warning signs.

In many cases, labor is induced with medication.

Vaginal delivery is often medically preferred because it usually carries fewer maternal risks than cesarean surgery when the fetus has died.

Cesarean delivery may still be needed in certain circumstances.

The timing and method of delivery depend on:

• gestational age;
• maternal health;
• bleeding;
• previous uterine surgery;
• personal circumstances;
• medical urgency.

Pain relief and emotional support should be offered.

Evaluation may include:

• examination of the placenta and umbilical cord;
• fetal examination;
• autopsy when consented to;
• genetic testing;
• maternal blood tests;
• infection testing;
• review of prenatal records;
• testing for selected medical conditions.

Families may choose which investigations they are comfortable with.

Even extensive testing does not always identify a cause.

However, a subsequent pregnancy may involve:

• increased anxiety;
• more frequent prenatal appointments;
• additional ultrasound monitoring;
• earlier fetal surveillance;
• closer monitoring of maternal medical conditions;
• individualized planning for delivery.

The timing of another pregnancy should consider physical recovery, emotional readiness, medical findings, age, and previous pregnancy complications.

There is no single correct waiting period for everyone.

For example, recurrence may be influenced by:

• placental disease;
• hypertension;
• diabetes;
• fetal growth restriction;
• genetic conditions;
• unexplained previous stillbirth.

A previous stillbirth may increase future risk compared with someone who has never experienced one, but most subsequent pregnancies do not end in another stillbirth.

Preconception counseling may help clarify individual risk.

Possible responses include:

• shock;
• sadness;
• anger;
• guilt;
• numbness;
• depression;
• anxiety;
• traumatic stress;
• fear of another pregnancy;
• difficulty being around babies or pregnancy-related events.

Partners may grieve differently.

Parents may also value opportunities to:

• see or hold the baby;
• take photographs;
• create memory items;
• name the baby;
• involve spiritual or cultural practices.

There is no correct way to grieve.

A person may experience:

• reduced sexual desire;
• fear of another pregnancy;
• discomfort with genital touch;
• sadness during intimacy;
• increased desire for closeness;
• difficulty separating sex from conception or loss.

Physical recovery after delivery also matters.

Sexual activity should resume only when the person feels physically and emotionally ready and any medical restrictions have ended.

Partners should avoid pressure and communicate openly about boundaries and contraception.

Pregnancy may therefore become possible before cycles appear to have fully returned.

People who do not want another pregnancy immediately may need contraception.

Those who wish to conceive again should discuss:

• previous stillbirth findings;
• medical conditions;
• medication;
• folic acid;
• pregnancy spacing;
• future prenatal monitoring.

A stillbirth does not automatically mean infertility.

Stillbirth is generally not caused by ordinary activities such as:

• walking;
• routine exercise;
• working;
• sexual activity;
• everyday household tasks;
• ordinary emotional stress.

Some health factors can influence risk, but many causes are outside anyone’s control.

Medical investigation may help provide answers, but sometimes uncertainty remains.

Stillbirth always has an identifiable cause.
No. Some cases remain unexplained.

A cord around the neck always causes stillbirth.
No. Nuchal cords are common and usually harmless.

Sex during pregnancy causes stillbirth.
Generally no. Ordinary sexual activity does not usually cause fetal death in an uncomplicated pregnancy.

One stillbirth means future pregnancies will also end in loss.
No. Many people later have healthy pregnancies.

Parents should recover emotionally within a specific time.
No. Grief varies greatly in duration and intensity.

1. Stillbirth refers to fetal death later in pregnancy according to medical or legal criteria.
2. The placenta was examined after the stillbirth.
3. Can someone have a healthy pregnancy after a stillbirth?
4. Reduced fetal movement should be reported promptly.
5. Preeclampsia and placental dysfunction can increase stillbirth risk.
6. The family chose genetic testing as part of the investigation.
7. Pregnancy after stillbirth may involve additional monitoring and anxiety.
8. Understanding stillbirth helps readers distinguish later pregnancy loss from miscarriage, neonatal death, and infertility.

The loss may change how a person experiences sex, closeness, pregnancy risk, and future family planning. Some people want intimacy soon afterward, while others need substantial time before sexual activity feels comfortable.

Understanding stillbirth helps reduce self-blame, supports compassionate grief care, and recognizes that sexual recovery and reproductive decision-making may continue long after physical healing.