When is a stillbirth?
Depending on the country, there are different definitions for a stillbirth. The decisive factors are the week of pregnancy and the birth weight of the child at the time of death.
In Germany, a child is considered stillborn if it shows no signs of life at birth after the 22nd week of pregnancy and weighs at least 500 grams. In this case, the parents may give the child a name. This name is entered in the death register. The registry office will issue a certificate for your child, which you will need for social security agencies and employers. Unlike in the case of a miscarriage, after a stillbirth you are entitled to maternity protection, family allowance and a postnatal midwife.
Stillbirth: Sometimes unexpected, sometimes with signs.
For some women, bleeding, abdominal pain and/or lack of fetal movements announce that something is wrong. The ultrasound may confirm the suspicion: the baby in the womb shows no signs of life! Sometimes, however, everything seems to be as usual, so that the doctor unexpectedly detects the death of the baby during the check-up.
Perhaps the gynecologist diagnoses a severe malformation in the unborn child, with which it is not viable and will die shortly after birth. To prevent such a severely damaged child from surviving birth, fetocide (purposeful killing of an unborn child in the womb) may sometimes be necessary.
All scenarios end in the same hopeless situation: the stillbirth of the beloved baby.
Shock news stillbirth
Many women, as soon as they learn of the death of their child, want to end the inconsolable and hopeless situation as quickly as possible and by cesarean section. However, take your time. You have built up an emotional bond with your unborn baby during the weeks of pregnancy, which has now come to an end completely unexpectedly. Separating too quickly by cesarean section makes it difficult to say goodbye and can have a lasting impact on the grieving process.
It is therefore often better to give birth to the dead child, which is possible in most cases. Ask your gynecologist or midwife for detailed and calm advice about such a “silent birth”.
The “silent birth
If the child is not viable due to a severe malformation, it may be born alive and die in the arms of its parents a few minutes or hours later. To ensure that your baby does not suffer in the process, the doctor will administer a painkiller or give breathing support if necessary. Basically, you are not alone in this situation. Doctors and obstetricians are there to support you.
Causes of stillbirth
After a stillbirth, many parents are tormented by the question of “why”. An answer to this question can be important for the grieving process, for coming to terms with what they have experienced, and also for subsequent pregnancies.
Reasons for a stillbirth can be:
- Disorders of the placenta, e.g., circulatory problems or premature detachment of the placenta
- Lack of oxygen for reasons other than a placental disorder
- Infections that harm the baby or the placenta and are transmitted through the amniotic fluid or the membranes of the egg
- insufficient supply of the child via the umbilical cord (umbilical cord knots, umbilical cord prolapse, umbilical cord around the neck)
- fetal malformations
autopsy after stillbirth
Postpartum after stillbirth
Whether stillbirth or cesarean section, the postpartum period is a sad time for most mothers. For the body, there is no difference between live and stillbirth: an empty abdomen, afterpains and the onset of milk production are present in both cases. In a stillbirth, all this is a daily reminder of the painful loss. This is the beginning of what can be a prolonged period of mourning.
In the period after the stillbirth, midwives are often the first point of contact. They are there to help with physical and emotional problems and provide helpful information, for example, about a special postnatal regression course for women after a stillbirth.
After a stillbirth, health insurance covers the cost of a postpartum midwife for several weeks.
Farewell rituals
After a stillbirth, parents, siblings and relatives should be able to say goodbye. It is possible to lay out the body in the clinic, at the funeral home or at home. Afterwards, you can bury your dead child in the family grave or in a child’s grave. Cremation or burial in the ground as well as burial outside the cemetery in a tree grave or burial at sea are possible after a stillbirth.
Mourning after stillbirth
Mother, father, siblings, relatives – everyone who was looking forward to the baby is grieving. Everyone does this in their own way: Some silently and introspectively, others tearfully and with loud wailing. Understanding and compassionate friends and relatives who stand by you and to whom you can pour out your heart are a gift.
Special commemorative days (birthday, “Worldwide Candle Lighting”), the care of a child’s grave and keeping a diary are ways of living out the grief and processing what has happened. This is important so that later the memory of the stillbirth is no longer felt only painfully, but is also associated with love and gratitude towards the lost child.
Stillbirth – then and now
A lot has changed in the last decades. In the past, it was assumed that the bond between mother and child was formed only after birth, and the sight of the dead child would aggravate the trauma. Therefore, in the case of stillbirth, women did not get to see their child and there was no burial. However, the experiences of affected women show that seeing and feeling the child has a positive effect on the grieving process. The little being is thereby – even if only for a short time – part of life and accepted as a full human being.
