Deciphering Stillbirth: Common Causes and Tests

From small losses to horrible tragedies, it's natural to want to understand how and why some things happen. For parents who have lost a baby to stillbirth (defined as pregnancy loss from the twentieth week to delivery of the baby), the shock and sadness are overwhelming.

The mother often struggles with feelings of guilt. "In the absence of a concrete explanation for what has gone wrong and why, it's easy for mothers who have experienced a loss to blame themselves for their babies' deaths," write Ann Douglas and Dr. John R. Sussman, MD, authors of Trying Again: A Guide to Pregnancy After Miscarriage, Stillbirth, and Infant Loss."

Unfortunately, why stillbirth happens remains a mystery of modern science. Dr. Cathy Spong, MD, chief of the Pregnancy and Perinatology Branch at the National Institute of Child and Human Development (NICHD), says, "Currently, it's very hard to come up with answers [about why stillbirth happens] and offer how we can prevent it from happening again. As a physician, I want to be able to promise high-risk patients that we can assure them a healthy baby, but I know that I can't promise that."

One of the main challenges researchers face is that stillbirth is defined differently state by state. "It's also underreported," asserts Dr. Spong. "Fetal death reports are not required. So we are left asking, 'How big is the problem?'"

The MISS Foundation, a national non-profit organization that helps parents who have lost an infant or child, reports that about 30,000 babies are stillborn each year. Approximately 60 percent of stillbirths are unexplained. Those cases that do have determined causes usually fall into one of the following key categories: