Stillbirth, Neonatal Death and Late Term Pregnancy Loss

Including Stillbirth and Neonatal Death

No matter how old your baby is when it dies, it is a horrible tragedy. There are some things to look at in terms of what causes these tragedies and what you need to know both for your current pregnancy, but also for future pregnancies as well. Many of your ansers will come from your medical care and the team you have assembled, but it is also fairly common that even with the best care, this was not something that could have been avoided. You may also be frustrated with a lack of answers as to why this happened. Talking to your team will help you answer questions you have both in the immediate term and in later months, and potentially even new pregnancies.

Pregnancy Loss in the Second Trimester

A sad pregnant woman in the second trimester
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Technically between the end of the first trimester and twenty weeks is a period of time that is really known as late miscarriage. The causes can be because of genetic problems with the baby or a missed miscarriage, when your baby died earlier in the pregnancy and it wasn't discovered until later. Some other things that can cause a loss in this portion of pregnancy include incompetent cervix (where the cervix doesn't hold closed), infections (of the uterus, amniotic sac, etc.) and other complications of pregnancy.

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Stillbirth

Ultrasound equipment
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The stillbirth rate is about 1 in 160 pregnancies after the twentieth week of gestation. Stillbirth is where a baby dies sometime before birth. The majority of stillbirths happen due to complications of pregnancy, including high blood pressure, diabetes and other problems. These complications are likely to have been identified in prenatal care.

If a mother is not receiving prenatal care, she has a much greater risk of her baby dying than if she is being managed by a physician. That being said, there are mothers who receive excellent care who still suffer from stillbirth. Talk to your practitioner about fetal kick counts and other ways to help you monitor your baby's health.

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Neonatal and Infant Death

Baby in the NICU
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Neonatal death is the death of an infant within the first 28 days of life. Deaths after this period are considered infant deaths. The vast majority of neonatal deaths are due to prematurity. While there are certainly babies who are surviving at very earlier gestational ages, it is still not in as high numbers as full term babies.

A baby born at 24-25 weeks of gestation, still only has a 50% survival rate. This also does not take into consideration quality of life or abilities, simply the status of being alive. In addition to prematurity, there are also neonatal deaths due to complications of disease as well as genetic problems, like trisomy 13 or anencephaly.

There are also deaths due to other factors which may include health conditions, not related to prematurity or genetics. Or you may experience a loss due to Sudden Unexplained Infant Death Syndrome (SUIDS) or Sudden Infant Death Syndrome (SIDS). And a small number of infants will die in accidents as well. 

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Rainbow Babies

Rainbow baby
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A rainbow baby is the term used for a baby born after a previous pregnancy or infant loss, regardless of the stage of loss. This is to signify that the newest baby has brought sunshine after the rain, but is not a replacement for the other baby, but a much wanted addition. 

A rainbow pregnancy and baby may leave you with many questions, even if you felt confident prior to this pregnancy. You may wonder what you can do to help avoid another loss or worry about emotions that may come up in a new pregnancy. This is completely normal. 

In addition to your regular prenatal care, you may want to consider seeing a counselor who has experience with grieving parents. There may also be support groups in your area who can assist you. To find one, ask your doctor or midwife, or call your local hospital for information. There are also online options for supportive communities as well. Each group may have a different style or feel, so don't think that you've seen one, you've seen them all. 

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