Stillbirth Prevention: Actionable Things You Can Do to Reduce the Risk of Stillbirth

Today we’re talking about stillbirth prevention. And I know that this topic can be very heavy and can provoke anxiety for a lot of mamas. It’s not something that anyone really wants to talk about.

But even though this info may make you uncomfortable, it’s SO important to talk about it. As someone who has cared for mamas experiencing a stillbirth, it is not something I would wish on even my worst enemy.

So, bear with me as you go through this article, and remember I am NOT trying to increase your anxiety. Our goal at Mommy Labor Nurse is to bring awareness to this topic and help reduce the number of preventable stillbirths that happen every year.

Here you’ll learn about what stillbirth is, some statistics surrounding this tragedy, risk factors, and some actionable things you can do to help prevent stillbirth.

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What is stillbirth?

By definition, stillbirth is the death of a baby any time after the 20th week of pregnancy or during delivery. Any death or loss that occurs before week 20 is defined as a miscarriage.

Beyond the broad definition of death after 20 weeks up until delivery, the CDC explains that stillbirth is broken down into early, late, or term.

  • An early stillbirth happens between 20 and 27 weeks
  • A late stillbirth happens between 28 and 36 weeks
  • And a term stillbirth happens any time after 37 weeks up until delivery

What are the statistics surrounding stillbirth in the US?

The statistics around stillbirth in the United States show that stillbirth is a lot more prevalent than many women realize. To help you digest and understand the reality of the risk, I am going to list out the facts:

  • Stillbirth affects around 1 in 160 births in the US
  • This totals a little more than 22,000 stillbirths per year
  • Stillbirth is 10x more common than SIDS, yet is discussed far less
  • An estimated 25% of stillbirths are classified as potentially preventable
  • Only 10% of stillbirths are due to genetic abnormalities

(source 1, source 2)

Are there risk factors?

The answer to this question is that yes there are risk factors for stillbirth – but I don’t want this to lead you into a false sense of security (or anxiety!).

Risk factors mean that you may have a slightly increased risk for stillbirth, but not having a risk factor doesn’t mean you are entirely in the clear either. It really can strike anyone and shows no boundaries.

With that said, let’s take a look:

  • Pregnant women of color
  • Over the age of 25
  • Low socioeconomic status
  • Smoke during your pregnancy
  • Have certain medical conditions (high blood pressure, diabetes, obesity)
  • Pregnant with multiples
  • Previous pregnancy loss
  • Lack access to quality prenatal care
  • Lack access to social and emotional support resources

Is there any way to prevent stillbirth?

Now that we’ve determined the risk factors, and that stillbirth can, unfortunately, affect any mama at random, let’s talk about prevention. You’ll remember above that I mentioned an estimated 25% of stillbirths are considered potentially preventable…so what gives?

My friends over at PUSH for Empowered Pregnancy are doing incredible work for this effort. They provide the most comprehensive information and actionable tips I’ve seen to really do something about these outrageous facts.

When I collaborated with them back in August of 2021, they provided me with concrete advice that I am pulling for this article to help get the word out.

There is no pregnancy safe zone

The first of that advice is to remember that there is no “pregnancy safe zone” when it comes to loss. Things can go wrong even in healthy, low-risk pregnancies. While death in pregnancy is less common after week 12, it is certainly still possible and isn’t as rare as we think (like we established above!).

Simply knowing this as a fact, and having information about how to spot a problem is so powerful to helping your provider intervene accordingly.

I believe knowledge is power, but for some reason there is this weird (and far too prevalent!) theory that women may become hysterical and overly stressed if they are informed about stillbirth, which sets them up for failure.

I hope you’ll agree with me that this is INSANE! We cannot decrease the rate of stillbirths without empowering mamas and their partners with the signs of fetal distress and teaching them how to advocate for themselves and their babies.

7 Tips to reduce the risk of stillbirth

Now that we’ve set the stage, I want to get into the tips to reduce stillbirth from the wonderful work of the women over at PUSH for Empowered Pregnancy.

1.      Always ask

All right, this first tip is really about empowerment. You should NEVER hesitate to call your healthcare team – or better yet, GO to the ER/labor & delivery – if you have any concerns (I will get into that in a second).

It very well might be a false alarm, but it’s never wasted effort and in L&D we NEVER mind you coming in. Your providers know that change in movement is a sign of potential complications and I promise you that they’d rather hear from you every single time than risk you being that one instance that ends in stillbirth. 

There are a lot of studies out there that report pregnant women feeling worried about calling their provider and having the perception of “wasting their time”. This is a real thing that pregnant women are thinking, and a real problem! You cannot be afraid to raise the red flag – it might save your baby’s life.

Related Reading: 5 Warning Signs to Always Call Your Doctor

2.      Use your mom voice

When you do contact your provider with a concern – you should always be heard and taken seriously. Full stop.

If your provider isn’t hearing your concern, keep insisting. Mama, do whatever it takes to be heard. If needed you can bring a support person to back you up, or even get a second opinion from another provider, or another practice entirely.

You should never go home without proper testing and reassurance. 

The fact is that you are your baby’s best advocate and no one knows your body or your baby better than you! If your gut is telling you that something is wrong – keep advocating until you see results that put you at ease.

You, your baby, and your care providers are a team, and if they aren’t acting like a supportive teammate, find someone who will! 

Related Reading: 23 Ways to Advocate for Yourself in Pregnancy, Birth, and Postpartum

3.      Know your normal

One of the best ways to keep your baby safe is by bonding with them inside your belly! Getting in tune with them will help you know their typical movement patterns. You want to have a sense of how often they typically move, how strong their movements are, and if certain things you do typically cause a response (ie: music, cold drinks, or changing positions).

By knowing your normal, you’ll be more aware when things AREN’T normal – or just seem off – and this is exactly when to make that call.

Take your intuition seriously, even if you can’t quite pinpoint *why* – pediatricians have been trained for decades to trust a mother’s gut feelings when it comes to their baby, and that connection starts during pregnancy. You are a mom ALREADY! 

4.      Count the kicks

Once you hit week 28 of pregnancy, it’s very important to do daily kick counting. This is where you lie quietly for 2 hours and try to feel 10 movements.

Research shows that kick counting is a free and SUPER effective way for mamas to track baby’s wellbeing, spot potential problems, and prevent stillbirth!

Here’s how to do it:

  • Set aside time once per day to lie or recline in a quiet place and focus on baby’s movements
  • Try to do your kick counting when baby is usually active, for most this is at night or after meals
  • According to ACOG, you should feel 10 movements in two hours
  • Movements can be kicks, flutters, swishes, rolls, jabs, or anything in between
  • All babies are different – some mamas will feel 10 movements in 10 minutes, others might take the full two hours
  • Kick counting regularly helps you notice YOUR baby’s unique movement patterns, which will make it easier to spot a change
  • If baby doesn’t seem to be moving, try laying on your left side or having an ice-cold drink

As you do this, I want you to be aware of your baby’s typical movement patterns and remember that just because baby is getting bigger DOESN’T mean they will move less.

If you have any sense that your baby is moving less than is typical for them, or you do not feel 10 movements in 2 hours, call your provider immediately, or just head straight to the ER if your gut is telling you something really isn’t right.

The Count the Kicks app is a great tool to get you started and provides data to share with your provider should you notice a change in movement patterns.

It even has a function to track strength of movements (1 to 5; fluttery to fierce). 

5.      Movement matters

When we say that movement matters, we’re not just talking about them happening in general, but about the strength and speed.

There is a hugely problematic myth that babies “slow down” or move less as they get bigger. THIS IS NOT TRUE!

According to PUSH for Empowered Pregnancy, movements should get stronger right up through birth, though the style of movement will change as they have less room to wind up and kick you.

A change in movement, whether faster or slower, can be your baby’s way of letting you know they are in distress and need intervention.

6.      Respond urgently to change

Just to drive home the points made in the other tips, I wanted to put this one separately – your response to change needs to be urgent! If an emergency is happening, every minute matters.

Don’t wait to be seen if you ever have any concerns, even if you have an appointment the next morning or later in the day.

If baby is in a vulnerable position, things can go south very quickly – this might be your only chance to act, and you might quite literally be saving your baby’s life.

A reassuring NST or ultrasound may not show what is causing your baby to be in distress, so if you are still noticing movement changes be direct with your medical team and make sure they consider intervention options (early delivery if necessary) instead of a wait and see approach. 

Related Reading: Learn More About NSTs and Follow-Up Testing

7.      Take precautions against COVID-19

Did you know that emerging research is showing that COVID-19 in pregnancy not only poses a greater risk to mom but is associated with poor outcomes for baby, too?

Pregnancies with COVID infection are as high as 4 times more likely to end in stillbirth (source)! Beyond that, COVID-19 in pregnancy is associated with an increase in preterm birth, preeclampsia, heart complications, and more.

The best line of defense here is to get your COVID vaccine. I know that this is a hot button issue, but it is not one I will stay silent on! Vaccination is the best thing you can do for yourself and your unborn baby.

To learn more, listen to my interview with OBGYN, Dr. Marta Perez, where we talked facts about the COVID vaccine and pregnancy.

Continue learning and find support

There are a number of wonderful organizations and resources out there to help you learn about preventing stillbirth, cope with a stillbirth, navigate pregnancy after a stillbirth, and support a loved one experiencing this reality.

Resources:

Liesel Teen, BSN-RN
Founder, Mommy Labor Nurse

Meet Liesel Teen

Hi there. I’m Liesel!

As a labor and delivery nurse, I’ve spent countless hours with women who felt anxious — even fearful — about giving birth. I want you to know it doesn’t have to be that way for you!

When you know what to expect and have the tools to navigate the experience, you’ll feel confident and in control.

I believe you deserve a better birth — no matter how you deliver.