A stillborn is a baby who was born dead or died during childbirth at 24 weeks of gestation or later. Before this period, preterm birth is considered to be a miscarriage, the fetus is dead, and the dead fetus is disposed of as biological waste. The longer the gestation period, the more difficult it is for a woman to accept the death of a child. Features of the course of pregnancy, types of delivery and the consequences of giving birth to a dead child will be considered further.
How to recognize fetal death during pregnancy?
In addition to regular visits to the gynecologist, a pregnant woman is able to independently assess the viability of her child through constant monitoring of his movements. In the first pregnancy, a woman begins to feel fetal movements after twenty weeks, in the subsequent pregnancy after sixteen. From this moment you should always fix how often and intensively the baby moves. If there are any deviations from the usual regimen, this is an occasion to urgently consult a doctor. Especially when the cessation or reduction of movement is accompanied by bleeding.
The doctor, first of all, listens to the fetal heartbeat. If it is not heard, the woman will be sent for an ultrasound scan, where an ultrasound specialist will accurately determine whether the child is alive. It may even be possible to find out the cause of the death of the child by identifying pathologies incompatible with life.
Delivery
After the intrauterine death of the child is established and reliably confirmed, the woman is given a referral for the necessary tests and is prepared for delivery.
If it is a short term, then this will be an abortion, which is relatively easy and painless for most women to undergo, since the procedure is under anesthesia and the woman wakes up without a fetus.
If the gestational age has crossed the threshold of twenty-four weeks, then the pregnant woman will have to pass a serious test, physical and psychological. After preparation, the woman will be injected with the hormone oxytocin, which will provoke uterine contractions and the onset of natural birth. After going through contractions and attempts, just as in the case of conventional births, a woman will be allowed from a stillborn child.
Death during childbirth
Another option is the death of the baby during childbirth. Such cases are thoroughly investigated, since there are many possible causes of death in childbirth. From natural, physiological, for example, the birth of a premature non-viable fetus or having multiple pathologies. Until the negligence of the staff of the hospital, which through their unskilled actions, or inaction, provoked the death of the baby. In this case, the perpetrators will be deservedly punished.
After such tragic events, some parents want to see their child and say goodbye to him. Do not rush with such a decision, a child born much earlier than the due date, or having multiple malformations, can cause great damage to the psyche and fear of future pregnancies. It might be worth talking to a psychologist about this. If parents are confident in their choice, hospital staff should not prevent them from saying goodbye to a stillborn child.
He was born dead: why?
A stillborn child was born in the family, what should I do? First, find out why. A baby can be born dead for a variety of reasons. They need to be clarified. For this, a forensic medical examination is prescribed. During the examination, samples of the placenta and umbilical cord are examined, genetic tests and autopsy of the baby are carried out. It will be difficult for parents, but you need to understand that finding out why a child was born dead is only possible. In addition, research may be useful for the future family. If the child was not viable due to genetic abnormalities, then before planning the next pregnancy, you should definitely consult with a geneticist, perhaps a defect in the genes of one of the parents will prevent them from becoming biological parents, and it would be better to consider alternatives.
If a stillborn child was born due to an accidental mutation or infection, then after appropriate treatment, you can continue attempts to give birth to a healthy baby.
Autopsy
A mandatory point in the study of the causes of death of a child is an autopsy. Parents have the right to refuse him for personal, religious or any other beliefs. The staff of the hospital is obliged to provide them with full information about the procedure, its goals and the results that it can give. You should not think too long, because the sooner the autopsy is performed, the more comprehensive information can be gleaned from it.
Causes
There can be several reasons for the appearance of a stillborn child:
- Lag in the development of the fetus. This may be due to insolvency of the placenta or deviations in the formation of the fetus.
- Detachment of the placenta. In the case of this pathology, nutrients cease to flow from mother to fetus, and he dies.
- Congenital malformations of the fetus. They are caused by genetic abnormalities and chromosomal defects, they are usually multiple and do not allow the child to stay alive.
- Infections and viruses. Sexually transmitted diseases are particularly dangerous, therefore it is very important to undergo all examinations and, if necessary, treatment when preparing for pregnancy or at its first stages. This will protect the unborn child from developmental disorders.
- Inferiority of the umbilical cord. Through the umbilical cord, the fetus receives oxygen and nutrients, if it is insolvent, then hypoxia and death of the fetus may be a possible complication.
- Deep prematurity. Currently, the duty of doctors to care for children weighing 500 g or more is fixed at the legislative level, but due to their immaturity this is not always possible.
- Preeclampsia
- Rhesus conflict of mother and child, when mom has a negative Rhesus factor, and dad and baby are positive. The mechanism of development of this pathology is not fully understood. For some reason, some women develop it, while others do not. In any case, vaccines have now been developed that need to be administered at certain stages of pregnancy and after childbirth; you also need to regularly donate blood for antibodies.
- Other causes, such as hypoxia during childbirth, cord entanglement, birth injury.
Risk group
No one is safe from fetal death, but there are risk factors that must be considered:
- If a woman has already had unsuccessful pregnancies and the first child is stillborn.
- A woman suffers from hypertension and preeclampsia.
- A woman has a history of chronic diseases: diabetes, pyelonephritis, thrombophilia, endocrine disorders.
- Serious pregnancy complications.
- Bad habits: smoking, alcoholism, drug addiction.
- Pregnancy is multiple. The greater the number of children, the greater the risk of having stillbirths. Why is the hospital so scrupulous about multiple pregnancies? Precisely because the various risks are increasing.
- A pregnant woman is obese.
- Pregnancy came as a result of IVF.
- Too young or old.
How to warn?
When planning a pregnancy, both prospective parents need to undergo an examination and, if necessary, treatment.
In the presence of chronic diseases, it is necessary to warn the gynecologist about this as early as possible, so that he knows what nuances to pay attention to. If the pregnant woman takes medications, it is necessary to coordinate this with the doctor and, possibly, replace with safer ones for the fetus.
Be sure to take folic acid from the first days of pregnancy and multivitamins as prescribed by your doctor.
In case of problems with obesity, the best preparation for pregnancy will be weight loss.
Bad habits should also be left for a later period.
Bleeding should be taken very seriously and not wait for everything to go away by itself. You should immediately consult a doctor, perhaps this is placental abruption.
It is good if the pregnant woman has the habit of counting fetal movements daily. This will allow you to notice the slightest deviations from the usual activity of the fetus.
What to do next?
Parents must receive documents for a stillborn child. In this case, no benefits are provided other than payment of sick leave for pregnancy and childbirth, but it is necessary to confirm the fact of his birth.
Where are stillborn children? Parents decide whether to bury or cremate their child and organize the ritual.
If the family is poor, you can contact the social protection authorities for material help for burial.
How to deal with pain?
Of course, it is insanely difficult for a mother to survive such an event in life. The birth of a stillborn child occurred in the family, how to live on? Returning to a normal lifestyle is not easy, especially if everything was prepared for the child: a stroller was bought, a cot was assembled, clothes were washed and ironed for discharge from the hospital. The father of the child and other relatives should support the woman as much as possible, and make the discharge from the hospital as traumatic as possible. It may be better to remove all reminders about the child from home, but it’s worth gently discussing these issues with the woman and asking her opinion, because she can perceive this as a betrayal.
A man needs to be patient and caring, as his wife will be in deep stress for the first time. Perhaps the family should consult a psychologist. The specialist will help to accept and survive the loss, to tune in to the future. The main thing is not to move away from each other and support in such a difficult situation.
What happens to the body?
Rehabilitation of a woman after giving birth to a dead child is similar to the consequences of ordinary childbirth. In the first few days, the so-called lochia - bloody discharge will abundantly leave the vagina. Menstrual pains in the lower abdomen indicate uterine contractions.
The most unpleasant will be the arrival of milk. The body is ready to feed the baby. You can just wait and wait until it burns out by itself, or use medications to stop lactation.
Psychologically, it will be easier to lie separately from the mothers who gave birth, who will feed, and be touched by their children. It is best to check out of the hospital as soon as possible if there are no health problems.
6-8 weeks after discharge, you need to come for a scheduled examination by a gynecologist. He will evaluate how the uterus contracted, what discharge will be at that moment, if there are any inflammatory processes. If necessary, an ultrasound examination will be prescribed.
The body will fully recover within a year after childbirth, subject to proper nutrition and exercise. Coping with psychological problems can be much more difficult.
If such an unpleasant event happened as the birth of a stillborn child, when you can become pregnant, the reviews are very diverse. It is necessary to consult with a geneticist and other highly qualified specialists. But, as practice shows, not earlier than in a year.