A stillbirth is defined as fetal death occurring after 20 weeks (or 24, depending on who you ask) of pregnancy. The majority of these occur before labor and delivery.
About 26,000 babies are stillborn in the U.S. each year, out of around 4 million babies. That’s 71 babies stillborn every day, roughly 1 in 160, or 0.6%. For context, approximately 2,500 infants who die of SIDS every year. Worldwide 1 in 45 (2%) babies are stillborn.
Tinsley and I are now counted among these painful statistics.
The cause of stillbirths is unknown in about two-thirds of cases. According to the American Pregnancy Association, the most common known causes of stillbirths include:
- Placental Problems: Women with placental abruption or preeclampsia have twice the risk of abruption or stillbirth as unaffected women. Sometimes insufficient oxygen and nutrients can also contribute to a baby’s death.
- Birth Defects: Chromosomal disorders account for 15-20% of all stillborn babies. Sometimes a baby has structural malformations that are not caused by chromosomal abnormalities but can result from genetic, environmental or unknown causes.
- Growth Restriction: Babies who are small or not growing at an appropriate rate are at risk of death from asphyxia both before and during birth, and from unknown causes.
- Infections: Bacterial infections between 24 and 27 weeks gestation can cause fetal deaths. These infections usually go unnoticed by the mother and may not be diagnosed until they cause serious complications.
- Others: umbilical cord accidents*, trauma, maternal diabetes, high blood pressure and postdate pregnancy (a pregnancy that lasts longer than 42 weeks).
*Women who have had umbilical cord issues with previous pregnancies, have as much as a ten-fold increased risk of umbilical cord issues in future pregnancies.
Recent research suggests that a quarter of stillbirths in the U.S. are preventable.
The vast number of fetal deaths occur during maternal sleep between the hours of midnight and 6am because of low maternal blood pressure and the production of melatonin. Tinsley died sometime between these hours.
Tinsley developed a very rare True Double Knot in her umbilical cord. These are fatal in about 1 out of 2,000 pregnancies, or .05%.
A True Knot can be defined as entwining of a segment of umbilical cord…commonly result from fetal slippage through a loop of the cord. They generally formed between 9 and 12 weeks of gestation, when the amniotic fluid volume is relatively large. It can also happen during labor.
Certain factors have been noted to increase their likelihood:
- long umbilical cords
- polyhydramnios (excess amniotic fluid)
- small fetuses
- male fetuses
- gestational diabetes mellitus
- monoamniotic twins
- undergoing genetic amniocentesis
If you want to read or participate in ongoing research about stillbirth, the International Society for the Study and Prevention of Perinatal and Infant Death (ISPID) publishes a Stillbirth Research Data Base.
The Star Legacy Foundation’s blog also offers current info about stillbirth from the medical community.