Getting a baby has been an ultimate goal for couples, having a baby is considered a blessing. But what happens when that baby dies during labor, grief and heart break. There are no words to explain about this tragic experience to couples who were expecting a baby. There are no enough words to ease the pain to a woman who carried the pregnancy for nine months that the baby is dead.
The CDC defines stillbirth as the death of baby in utero before or during delivery. This is also referred to as fetal death. The WHO recommends that, stillbirth is a baby born with no signs of life at or after 28 weeks of gestation, this is necessary for international comparison. [WHO]
Some people tend to interchange miscarriage or confuse between miscarriage and stillbirth. In United States, a miscarriage usually refers to a fetal loss less than 20 weeks after a woman becomes pregnant and a stillbirth refers to a loss 20 or more weeks after a woman becomes pregnant [CDC]. In 2015 there were 2.6 million stillbirths globally, with more than 7178 deaths a day, the majority of these deaths occurred in developing countries [WHO]
What are the causes and risk factors?
Almost half of stillbirths, 1.2 million happen when the woman is in labor. These deaths are directly related to the lack of skilled care at this critical time for mothers and babies. Before labor stillbirths account for 1.4 million deaths [WHO, 2011] The World Health Organization (WHO) has identified the following as the risk factors for stillbirth
- Childbirth complications
- Post-term pregnancy
- Maternal infections in pregnancy (malaria, syphilis and HIV)
- Congenital abnormalities
- Fetal growth restrictions
Impacts of stillbirth
- Parents who experience stillbirth are at risk of suffering from a number of detrimental psychosocial effects including grief, depression, anxiety, post-traumatic stress disorder and guilt and self-blame [The Joanna Briggs Institute, 2014]
- Women who experience a stillbirth or neonatal loss are blamed, neglected and in the case of repeated loss, dishonored [Sisay,Yirgu, et al; 2014, Journal of Midwifery and Women’s Health]
How to provide support?
Psychological support is vital for families faced with stillbirth this should be accompanied with pharmaceutical care if signs of anxiety, depression or post-traumatic stress disorder are evident.
Parents who have had stillbirth often suggest having someone who they can talk to and be listened, helps greatly at times like these
For healthcare provider, individualized, genuine and personal care is paramount. Patients appreciate when healthcare professionals show emotion, empathy and human reactions to their tragic experience [TheJoanna Briggs Institute, 2014]
Communication that is warm, sensitive, genuine and reassuring is important. Blunt, disengaged styles of communication and information provision can cause distress to parents and their families [TheJoanna Briggs Institute, 2014]
Where clinically appropriate, minimization of unavoidable delays or ambiguity in informing parents’ of the death of their baby are critical as these will be experienced and remembered negatively [TheJoanna Briggs Institute, 2014]