Stillbirth (Before Delivery): Care Instructions

Overview

Stillbirth is the loss of a baby after 20 weeks of pregnancy. When a baby dies while still in the uterus, this may also be called fetal loss.

A doctor may deliver the baby by giving you medicine to start labor. Or you may have a procedure called D&E (dilation and evacuation).

The loss of a baby can be hard. And you may wonder why it happened. Fetal loss can happen even during a pregnancy that has been going well.

In the weeks to come, try to take care of yourself physically and emotionally. Take care of yourself in whatever way feels best.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens next?

After a fetus dies, labor will usually begin on its own within 2 weeks. But if you don't want to wait that long, you can choose to have labor induced. This means going to the hospital and, usually, getting medicine that starts the labor process.

If labor doesn't start on its own, your doctor may take steps to get your labor going.

Your doctor may use medicine to soften your cervix and help it begin to open.
Then your doctor will likely give you medicine to start labor and keep your labor going.
You will be given medicine for pain if you need it.

After delivery, you will be able to see the baby if you want to. Although this can be hard, some people want the chance to hold the baby and say goodbye. Hospitals may have trained staff to help support you.

You will probably go home the next day.

Options instead of labor

You may be able to choose a procedure called a dilation and evacuation (D&E) instead of going through labor. Your doctor will discuss whether this is an option for you.

Delivery by cesarean section is rare in fetal loss. It is major surgery, so it's only done when going through labor would be more dangerous.

Deciding about autopsy

If the exact cause of death isn't known, you may face a decision about whether to have an autopsy. This can be a hard decision. But an autopsy may help you find out why a fetal loss happened and whether it could happen again. If you have had multiple fetal losses in a row, your doctor may suggest testing to check for other possible causes.

How can you care for yourself at home?

After a stillbirth, there are things you can do for your physical and emotional health and comfort.

Taking care of your body

You may have some bleeding. Use pads instead of tampons.
Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve), to ease cramps. Be safe with medicines. Read and follow all instructions on the label.
Ask your doctor about when it is okay to have sex.

Taking care of your emotional health

Rest whenever you can. Being tired can make it harder to cope with your emotions.
Try to eat healthy foods, get some sleep, and get exercise (or just get outside) while you heal.
Tell your family and friends what they can do. You may want to spend time alone, or you may seek support from family, friends, or religious or spiritual groups.
Talk to your doctor about how you are coping. The doctor will want to watch you for signs of depression. You may want to have counseling for support and to help you express your feelings. You can also call the Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262) for support.
Think about making a memory book of your pregnancy and baby. You may choose to name your baby and want to take pictures and keep a lock of hair. The hospital may take photos or footprints for you. Some people have a ceremony, such as a christening or other blessing or a memorial service.
If you can, try to talk to others who have gone through this loss. You can make connections online or in person. Here are some organizations that can help:
- The Compassionate Friends. This is a resource for people who have lost a child. The group can help put you in touch with one of its support groups in your area. Go to www.compassionatefriends.org for more information.
- Share (Pregnancy and Infant Loss Support, Inc.). This group can offer advice and connections to others who have lost a child. Go to www.nationalshare.org for more information.
- The International Stillbirth Alliance. This group offers information and resources. Go to www.stillbirthalliance.org for more information.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have severe vaginal bleeding.
You have severe pain in your belly or pelvis.
You have chest pain, are short of breath, or cough up blood.

Call your doctor now or seek immediate medical care if:

You have signs of preeclampsia, such as:
- Sudden swelling of your face, hands, or feet.
- New vision problems (such as dimness, blurring, or seeing spots).
- A severe headache.
You have a fever.
You have belly pain or cramping.
You have any vaginal bleeding.
You have had regular contractions (with or without pain) for an hour. This means that you have 8 or more within 1 hour or 4 or more in 20 minutes after you change your position and drink fluids.
You have a sudden release of fluid from your vagina.
You have low back pain or pelvic pressure that does not go away.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

Where can you learn more?

Go to http://www.healthwise.net/patientEd

Enter B273 in the search box to learn more about "Stillbirth (Before Delivery): Care Instructions".

The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.

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