Stillbirth is when a baby dies before she or he is born, after 24 weeks of pregnancy. In England, around 1 in 235 births is a stillbirth.
Not all the causes of stillbirth are currently known, but experience suggests that if pregnant women know the risk factors, the signs to look out for and when to seek help, this can reduce how often stillbirth happens.
It's not possible to prevent every stillbirth. But we do know that certain factors increase the risk, and there are simple things you can do to reduce these risks.
Go to all your antenatal appointments
It's important not to miss any of your antenatal appointments. Some of the tests and measurements that can identify potential problems have to be done at specific times.
Going to all your appointments will also mean your midwife can give you relevant information as your pregnancy progresses.
Eat healthily and keep active
Try to swap unhealthy foods for healthier options, and try to keep active. Being overweight or obese can increase the risk of problems in pregnancy.
Pregnancy is not the time for a weight loss diet, but you don't need to put on any extra kilos in pregnancy if you're already overweight.
If you smoke, the best thing you can do is to stop. Stopping at any time in pregnancy will help, though the sooner the better.
The NHS offers lots of support to help women stop smoking in pregnancy – your midwife, GP or pharmacist can advise you. There will be a stop smoking programme you can join.
Passive smoking (breathing in smoke from other people's cigarettes) is also harmful in pregnancy, so avoid being around people who are smoking if you can.
If your partner or someone else in your household smokes, they can contact NHS stop smoking services for support in quitting.
Avoid alcohol in pregnancy
The safest way to ensure your baby isn't damaged by alcohol is not to drink while you're pregnant.
If you're finding it hard to stop drinking, ask for help from your midwife or GP.
Find out about alcohol and pregnancy, including how many units are in different types of drinks.
Go to sleep on your side
Research suggests that going to sleep on your back after 28 weeks of pregnancy doubles the risk of stillbirth.
It's thought this may be to do with the flow of blood and oxygen to the baby.
The safest option is to fall asleep on your side, either left or right. Don't worry if you wake up on your back, just turn on to your side to go back to sleep.
Watch an animation from Tommy's about how to sleep safely in pregnancy.
Tell your midwife about any drug use
If you use or have used street drugs (such as cannabis, ecstasy or heroin) or other substances, tell your midwife.
The more your midwife knows about your general health, the better she or he will be able to help you and your baby.
Don't be afraid to share this information. It'll be treated in confidence and only shared with other relevant professionals if the midwife thinks it's in the best interests of you and your baby.
FRANK has information about the risks of "legal highs", which aren't necessarily legal or safe.
Have the flu jab
Make sure you have the seasonal flu vaccination, which is available from the beginning of October each year.
Pregnant women are more at risk from flu complications, such as bronchitis and pneumonia, than the general population. These complications can harm your baby.
Your midwife or GP will offer you the flu jab – it's free and safe to have at any stage of pregnancy.
Women who have had the vaccine in pregnancy also pass some protection on to their babies, which lasts for the first few months of the baby's life.
Avoid people who are ill
Wherever possible, avoid contact with people who have infectious illnesses, including diarrhoea, vomiting, and childhood illnesses like chickenpox or parvovirus (slapped cheek).
If you have been or are in contact with someone with an infection, speak to your midwife or GP for advice.
Wash your hands
Be strict about good hygiene wherever you are. This includes washing your hands to reduce the risk of infection, particularly:
- before preparing food
- after going to the toilet
- after changing a nappy, if you already have children
Prepare and store food safely
It's important to prepare and store food safely to reduce the risk of infection.
Avoid some foods in pregnancy
You should avoid some foods in pregnancy, as they have a higher risk of making you ill with infections such as listeria and salmonella.
Get to know which foods to avoid while you're pregnant, including raw or undercooked meat, some cheeses, and unpasteurised milk.
When to get help from a midwife or doctor
If any of the following happen, you should seek help straightaway by contacting your maternity unit.
Do not wait until the next day – contact them now.
Your baby's movements have reduced
Call your midwife or maternity unit straight away if you think your baby is moving less than usual (reduced foetal movement). They'll need to check your baby's movements and heartbeat.
Do not wait until the next day, or your next appointment or after the weekend – call your midwife straightaway, even if it's the middle of the night.
Do not use a home monitoring kit (doppler) to try to check the baby's heartbeat yourself.
This is not a reliable way to check your baby's health. Even if you hear a heartbeat, this doesn't mean your baby is well.
You can find out more about your baby's movements from:
You bleed from your vagina
This may indicate a problem – read about bleeding from your vagina in pregnancy.
You have vaginal discharge that is not normal for you
If you have watery, clear or coloured discharge from the vagina that seems abnormal for you, contact your maternity unit. This could be your waters breaking or signs of an infection.
You get blurred vision, severe headache, swelling
These could be signs of pre-eclampsia. Although pre-eclampsia is usually mild, in some pregnancies it can lead to life-threatening problems for both mother and baby.
Symptoms of pre-eclampsia include:
- obvious swelling – especially of the hands and face or upper body
- severe headache that does not go away – sometimes with vomiting
- problems with vision, such as blurring, flashing lights, spots or difficulty focusing
- severe pain just below the ribs in the middle of your abdomen
You have itching, particularly on your hands and feet
Call your maternity unit if you have itching (particularly on the hands and feet, but other areas of the body may also be affected), even if it's mild.
Itching in pregnancy is normal for most women, but it can mean you have a liver disorder called intrahepatic cholestasis of pregnancy (ICP, also called obstetric cholestasis).
If left untreated, ICP can lead to premature labour and increase the risk of stillbirth.