Stillbirth: understanding, risk reduction and support

This is the article nobody wants to open, so let’s be clear about why it exists: not to add fear to your pregnancy, but because stillbirth is talked about so little that the two things worth knowing — what genuinely reduces risk, and where support lives — often reach families too late or not at all. Ten minutes with the facts is protective. Then you can close this and go back to expecting your baby, which is overwhelmingly the likely outcome.

What it is, and how likely. In Australia, stillbirth means the loss of a baby from 20 weeks of pregnancy. It affects around one in every 140 pregnancies here — which means, turned around, that more than 99% of pregnancies that reach 20 weeks don’t end this way. Some stillbirths follow a known thread — problems with the placenta, infection, a baby’s condition, complications like pre-eclampsia — and some, painfully, are never explained even after investigation. It is almost never caused by anything a parent did or didn’t do.

The evidence-backed things that reduce risk are few, specific, and worth taking seriously precisely because the list is short:

• Know your baby’s movements, and act the same day if they change. From 28 weeks, your baby’s pattern should stay their pattern — babies do not “slow down at the end”. A change in movements is the single most important warning sign there is, and it’s an emergency-department-level reason to call your maternity unit immediately, any hour — never wait until morning, never rely on a home doppler. Calling and being wrong costs nothing; it’s what the service is for.
• Sleep on your side from 28 weeks. Going to sleep on your side (either side) rather than your back halves late-pregnancy stillbirth risk in the research. Waking up on your back doesn’t matter — just settle back onto your side.
• Don’t smoke, and avoid alcohol and other drugs — and get support to stop rather than doing it alone; your midwife will help, without judgement.
• Go to your appointments, especially in the third trimester — growth checks and blood pressure exist substantially for this reason — and flag risk factors (diabetes, previous loss, being over 40, itching without a rash) so monitoring can be tailored.

If the worst has happened and you’ve found this page in the aftermath: we’re so sorry. Nothing here will be adequate, but know these things. What happens next — time with your baby, photos, hand and footprints, naming — is yours to choose, at your pace, and the hospital’s midwives and social workers will walk you through options gently; many parents later treasure mementoes they weren’t sure about at the time. You’ll be offered investigations to look for a cause; they don’t always find one, but they can inform care in any future pregnancy. Your body will need tending too — milk may come in, and there is medication and support for that particular cruelty. And the paperwork (birth registration applies from 20 weeks, and parental leave entitlements still stand) is something the social worker can shoulder with you.

Support that understands: Red Nose Grief and Loss (1300 308 307) is Australia’s 24/7 line for pregnancy and infant loss, staffed by people who know this terrain — including peer supporters who have stood where you are. Hospital social work, your GP, and PANDA (1300 726 306) are part of the net too, for you and your partner both — grief rarely runs in sync between two parents, and both versions of it are valid. There is no schedule for this, and no wrong way through it.

And if you’re pregnant again after a loss — a chapter with its own particular weight — you deserve extra care by default: ask about continuity of care and additional monitoring, and see the pregnancy-after-miscarriage article for company in the anxious wait. However you arrived at this page: be gentle with yourself, and let your care team carry what they can.