Miscarriage, stillbirth and neonatal death

Why do babies die during pregnancy and birth?

Sadly 1 in 4 babies die during pregnancy and birth, and a further small amount die during the first year of life. The death of a baby is a deeply personal experience which affects people differently. No matter when in your pregnancy this happens, you may need support to help you come to terms with what’s happened.

Sometimes we know in advance the reasons for baby death, some babies become poorly and their growth slows or they stop growing altogether and are too small to survive, sometimes they become sick, perhaps a termination is planned for medical reasons. Some women become sick during pregnancy or babies can very sadly and very rarely die during the birth process. Other pregnancies are never even known about as they end so early we never know the true reason.

Who is there for you?

There is a specialist Baby Bereavement Service at the Dudley Group NHS Foundation Trust, based at Russells Hall Hospital. The service draws on the extensive experience of specialist midwives, chaplains, maternity and neonatal teams to provide personalised, supportive and sensitive care for those losing a baby. The team look after women who are experiencing miscarriage, stillbirth, termination due to fetal abnormality and babies who die shortly after birth (called a neonatal death). Emotional, physical and practical support is offered to help manage all aspects of baby loss. There are many charitable and national support services that also can help (detailed below).

Your antenatal care and your baby’s wellbeing

Throughout your antenatal care your midwives are constantly reviewing and monitoring you and your baby. This is done through face-to-face or telephone conversations, education, urine and blood pressure testing, blood tests and scanning.

Later in pregnancy understanding your baby’s movements is done by women themselves.  We know that when baby’s movements reduce or suddenly increase this can be a sign your baby is unwell and further monitoring in the hospitals Day Assessment Unit or Triage departments may be required so observations can take place and a decision made as to whether to deliver the baby early in some cases. For further information please see  feeling your baby move is a sign that they are well or movements matter video

Miscarriage

It is thought that around 1 in 5 women will have a miscarriage in their lifetime. Early miscarriages are those within the first 12 weeks – a lot of women do not realise they are pregnant, in most cases it is not possible to give a reason to these losses. In 1% of pregnancies the egg attaches itself to somewhere outside of the uterus. This is known as an ectopic pregnancy. For more information visit the NHS website.  Late miscarriages happen after 12 weeks up until 24 weeks, this is less common at 1-2% of loss. Support and guidance is available for parents who experience this grief see Miscarriage and your feelings for more information.

Stillbirth

At or after 24 weeks baby death is called stillbirth. This is a legal definition as these babies are most likely to survive if born, with support from the neonatal team.

For parents this can be the most devastating thing they will go through. If it is thought your baby may die during pregnancy, birth, or shortly afterwards, practical support such as additional testing, scans and medication, information, guidance for care or difficult decisions and planning that may need to be made about palliative care for your baby can happen.

Questions around stillbirth

It is natural to want to know and understand why your baby has died. This can be straightforward if the answer is clear, sometimes a doctor or coroner can run tests or do a post-mortem to find out this information. Sometimes we just do not know why we lose babies and this lack of understanding can be hard to live with. If you are sadly in this situation a midwife will be able to help and talk with you and guide you to a wider range of support.

Neonatal death

If a baby is born and they die within 28 days this is called a neonatal death. Most of these deaths are linked to babies born too soon or too small who are at higher risk of infection and serious health complications. Sometimes this happens even if they were born at full-term. This is because some babies are found to have genetic disorders, develop complications before, during or after birth, or develop a life-threatening infection.

For stillbirth and neonatal death, the maternity and neonatal team offers you and your baby dignity and privacy. They ensure you have time together as a family to spend with your baby in a private area to collect memories and maybe create memory boxes.

They will assist you to officially register your baby with a death certificate, so you can be offered a burial or cremation, which is free within the Dudley borough. Memorial services are regularly held throughout the area and can help with your grieving process.

It is also worth considering peer support by meeting other families who have experienced the death of their baby. You may also wish to link with charities or fundraise yourself to raise awareness of baby death so that further research on it can be conducted and more people understand how it affects families.

Who is there to support you through baby death?

Here is information available to you for emotional, practical and peer support. Talking about bereavement openly and honestly can help not only the way you feel but make each other feel less alone. It can also pave the way for greater awareness and more research to stop it happening.

o Best Beginnings offers videos about neonatal birth for small and sick babies

o Bliss Charity offers parents advice and support around bereavement including making critical care decisions, bereavement and palliative care

o Child bereavement UK offers support around stillbirth with informative videos

o Memorial services

o NCT talks about labour and birth and losing your baby

o NHS offers information about stillbirth and when pregnancy goes wrong.

o SANDS stillbirth and neonatal death charity

o CRUSE – Siblings often need support when a baby dies. CRUSE offers support to parents offering advice on how to support your other children to grieve for a death

o Tommy’s Charity offers extensive information to parents about the neonatal experience, including neonatal death support