What is a stillbirth?
A stillbirth refers to the death of a baby in the womb after 20 weeks of pregnancy. Unfortunately, stillbirth is more common than many people realize. In the United States, about 1 in 160 births ends in stillbirth, which amounts to around 24,000 stillbirths per year. A stillborn baby shows no signs of life upon delivery – there is no breathing, heartbeat, or movement. This is an extremely tragic outcome for expecting parents and families.
What causes a stillbirth?
There are a variety of causes of stillbirth, some of which are preventable while others are not. Some of the main causes include:
– Placental problems: Issues with the placenta like placental abruption (when the placenta separates from the uterine wall) or placental insufficiency (when the placenta cannot supply enough oxygen and nutrients to the baby). These cause about 1 in 3 stillbirths.
– Problems with the umbilical cord: When the umbilical cord gets twisted, compressed, or otherwise damaged, it can cut off oxygen flow to the baby. This accounts for up to 1 in 5 stillbirths.
– Birth defects: Babies with severe birth defects affecting vital organs are at higher risk of stillbirth. Examples include heart defects, lung problems, and chromosomal abnormalities.
– Infection: Maternal infections like syphilis, listeriosis, and cytomegalovirus can be passed to the baby and increase the risk of stillbirth.
– Chronic health conditions: Conditions like diabetes, high blood pressure, and obesity make stillbirth more likely if not well-managed during pregnancy.
– Smoking, alcohol, and drugs: These substances are dangerous during pregnancy and make stillbirth more common.
– Advanced maternal age: Stillbirth risk starts increasing after age 35 and is even higher after age 40.
– Racial disparities: Stillbirth rates are higher in black women compared to other races, even when factors like income and education are accounted for. The exact reasons are unknown.
– Umbilical cord accidents: Sometimes the umbilical cord gets wrapped around the baby’s neck or other body part, cutting off oxygen.
– Unknown causes: In many cases, even after thorough investigation, no cause of stillbirth can be found.
Is it possible for a stillborn baby to come back to life?
The short answer is no – a stillborn baby cannot come back to life. A stillborn baby has died in the womb prior to delivery.
There are no scientifically documented cases of a stillborn baby miraculously coming back to life. Once the baby has died in utero, unfortunately there is no way to revive him or her. The causes of stillbirth fundamentally impair the baby’s vital functions like breathing, circulation, and brain activity.
While extremely rare “near-stillbirth” cases have made headlines, these involve babies that were born with an extremely faint heartbeat and minimal signs of life. They were on the verge of stillbirth but were not clinically stillborn at the exact time of delivery. With quick medical intervention like CPR, some of these babies have survived. However, once a fetus has passed the threshold into actual stillbirth, revival is impossible with current technology and medical knowledge.
Can Stillbirths Be Predicted or Prevented?
An important question many expecting parents rightfully ask after learning about stillbirth is – could this have been predicted or prevented?
Predicting Stillbirths
Unfortunately, most of the time, stillbirth occurs suddenly and without warning. There is no reliable way to predict stillbirth in low-risk pregnancies.
However, there are some cases where careful monitoring and testing can identify babies that may be more vulnerable. These include:
– Growth problems or placental abnormalities detected on ultrasound. If the baby is not growing at the expected rate or the placenta appears damaged, closer monitoring can be done.
– Fetal movement monitoring. Decreased fetal movement may indicate potential problems. Mothers can track kick counts and alert their doctor if movement slows.
– Monitoring high-risk conditions. Careful tracking of chronic illnesses and taking medications as prescribed can lower risks.
– Genetic screening. Testing can detect some chromosomal problems associated with stillbirth risk.
– Monitoring late in pregnancy. Additional testing like kick counts, ultrasounds, and non-stress tests can offer reassurance.
Unfortunately, none of these are foolproof methods, and many stillbirths occur even under close observation. But being aware of potential problems and closely following a doctor’s recommendations offers the best chances for a healthy pregnancy.
Preventing Stillbirths
While some stillbirths cannot be avoided due to their sudden, unexplained nature, experts estimate that up to 1/3 of stillbirths could potentially be prevented with improved medical care and public health initiatives.
Some ways to lower the risk of stillbirth may include:
– Getting regular prenatal care throughout pregnancy to monitor for problems
– Controlling chronic health problems like diabetes and high blood pressure
– Taking folic acid supplements to lower birth defect risks
– Avoiding smoking, alcohol, and recreational drugs
– Treating infections promptly
– Managing problems like placental issues, growth restriction, or umbilical cord complications and delivering early if necessary
– Having testing for chromosomal or genetic issues and consulting a specialist if found
– Opting to deliver before week 42 if pregnancy continues past full term
– Following safe sleeping guidelines like avoiding sleeping on the back late in pregnancy
– Recognizing and promptly reporting decreases in fetal movement
– Addressing racial disparities by ensuring equitable access to quality prenatal care
While there are no guarantees, taking proactive steps can reduce risks. However, it’s important for parents to know that in many cases, tragedy simply cannot be foreseen or prevented. Support and compassion for grieving families is critically needed.
Can a Stillborn Baby Be Saved by Immediate Medical Intervention?
When a stillborn baby is delivered, it can be an extremely emotional and devastating experience for families. In their grief and desperation, some parents may frantically ask doctors to do anything in their power to try and revive the stillborn baby. However, the hard truth families must be told is that there is no medical procedure or intervention that can restart the life functions of a truly stillborn infant.
Once a baby has passed away in the womb prior to birth, the loss is irreversible. The baby’s organs have already sustained fatal damage. Interventions like CPR, emergency medications, and life support cannot bring back a baby already stillborn:
– CPR cannot restart the heart and lungs if the baby’s circulation and oxygen flow have already ceased function long before delivery. Stillbirth means cardiac arrest occurred hours or days prior.
– Medications require a functioning cardiovascular system to circulate through the body. They cannot revive organs that have already deteriorated.
– Assisted breathing via ventilator is impossible without functional lungs and respiratory centers in the brain. These have been compromised too long before birth.
– Aggressive measures like chest compressions can injure the fragile body but cannot fix the underlying loss of brain, lung, and cardiac activity.
As heartbreaking as it is, once a fetus has transitioned into stillbirth, the window for intervention has passed. The baby’s bodily functions have already failed beyond the point of medical rescue. However, families can be assured the medical team did everything within their power and respectfully cared for both mother and baby.
How is a Stillbirth Formally Declared and Diagnosed?
To formally diagnose a stillbirth, doctors follow several diagnostic steps:
– Examination for any signs of life: The doctor first thoroughly examines the baby for any evidence of vital activity. This includes listening for a heartbeat, checking for pulses, watching for breathing, and assessing muscle tone.
– Apgar score: The Apgar score rates factors like heart rate, breathing, color, reflexes, and muscle tone on a scale of 0-10. A stillborn baby will receive a score of 0.
– Umbilical cord blood gases: The blood gasses of a sample from the umbilical cord can show if the baby’s circulation was impaired.
– Additional testing: Further testing may include x-rays, MRI, blood samples, genetic testing, autopsy, and examination of the placenta. This can help determine potential causes.
– Official declaration: Once all clinical criteria confirm no life, the doctor makes a formal declaration of stillbirth and records the precise time. This allows death certificates and other paperwork to be finalized.
The diagnosis is very clear-cut medically, but psychologically it can still feel unbelievable for grieving families. It is vital that parents have ongoing emotional support. Many find it helpful to hold and take photographs with their stillborn baby. Respectful medical care and creating memories can aid the traumatic grieving process.
Are There Any Exceptions Where Revival was Possible?
Throughout history, there have been exceedingly rare accounts of infants born with no discernible life signs that somehow survived against all odds. While these cases do not technically meet the criteria for clinical stillbirth, they appear similar to stillbirth at first glance. However, it is important to understand the key differences:
– Extreme prematurity: Some of the youngest neonatal survivors were very premature babies born under 24 weeks gestation. Their organs were extremely underdeveloped, causing signs of life to be almost imperceptible.
– Birth defects: Babies with defects affecting the heart, lungs or diaphragm may need immediate surgery to begin breathing and circulating blood. Until corrected, they appear stillborn.
– Severe oxygen deprivation: Prolonged oxygen loss before birth but with a faint or undetectable heartbeat may result in a baby that looks stillborn. However, aggressive NICU resuscitation can sometimes support faint remaining activity.
– Misdiagnosis: Very rarely, a baby is thought to be stillborn but shows delayed signs of life up to 10 minutes after birth. This indicates the determination of stillbirth was incorrect.
– Miracles? In exceedingly rare accounts, babies revived 25 minutes or more after showing no signs of life at birth. The validity is debated and may be considered miraculous rather than medical revivals.
However, experienced doctors today use advanced technologies to confidently diagnose stillbirth in nearly all cases. True reversals of stillbirth are not thought possible with current medical knowledge. The exceptions illustrate the critical importance of immediately checking for any faint signs of life and attempting neonatal resuscitation when there is even a glimmer of hope for survival.
Support for Families After Stillbirth
Stillbirth is a deeply painful and traumatic loss for families. The grief after stillbirth is often described as a unique, devastating sorrow. Many parents benefit from seeking support to help navigate the grief process:
– Requesting referrals from doctors for grief counseling, therapy, and support groups. These provide helpful guidance from professionals and others who have experienced similar loss.
– Reading books and online resources about coping with stillbirth and honoring stillborn babies. The shared stories and advice help many feel less alone.
– Participating in remembrance rituals like holding memorial services, creating memorial gardens, writing letters to the baby, and getting tattoos. These actions can provide comfort and a way to honor the deep bond.
– Joining online communities and forums to connect with other grieving families and share their journey with others who fully understand their pain.
– Prioritizing emotional self-care during the intense grief by allowing time to cry, finding healthy distractions when needed, and asking loved ones for help with daily burdens.
– Considering grief counseling or therapy if trauma symptoms like severe depression or anxiety linger more than several months. This indicates potential complicated grief requiring professional support.
The deep sorrow after stillbirth often lasts long after formal support ends. Many parents say their lives are forever changed. There is no right or wrong way to grieve. Steps like preserving memories, being gentle with oneself, and openly communicating needs with loved ones can aid healing.
Conclusion
Stillbirth is a deeply tragic outcome no family anticipates. The experience is filled with complex medical questions and intense emotional pain. While miracles are hoped and prayed for, there are no scientifically documented cases of a stillborn baby being revived and surviving once death has occurred in the womb. However, ongoing research is improving opportunities to lower preventable risks through better medical care and education. Compassionate support of bereaved families is critically needed, now, and in the long-term grief journey ahead as parents remember and honor a life lost far too soon. Even though revival is not possible, the deep love for their baby remains forever.
