Advice for a safer pregnancy
Although not all stillbirths can be prevented there are ways of ensuring you are as healthy as is possible in pregnancy.
If you are a mother-to-be, we offer the following advice, but stress that if you have any concerns at all you should immediately talk to your GP or midwife.
Don't ever feel you should not bother them. Don't sleep on it - act on it.
Smoking cigarettes in pregnancy is associated with higher rates of stillbirth. If you smoke while you are pregnant your baby's growth and development are affected, and problems with your baby's health and wellbeing are much more likely. If you smoke you should stop – ideally before your pregnancy but even part way through your pregnancy it is still worth giving up smoking.
You can get advice on stopping smoking from your GP. You can also call the NHS Pregnancy Smoking Helpline on 0800 169 9 169 or visit NHS choices.
Avoid alcohol and drugs during pregnancy
Drinking alcohol and taking drugs during pregnancy can seriously affect your baby’s development, as well as increase your risk of miscarriage and stillbirth.
For more information on alcohol and drugs during pregnancy visit NHS choices.
Ensure you are a healthy weight
Obesity is a risk factor for stillbirth. The best way to protect your health and your baby’s wellbeing is to lose weight before you become pregnant. By reaching a healthy weight, you cut your risk of all the problems associated with obesity in pregnancy. Your GP can give you advice about how to lose weight.
If you're obese when you become pregnant, your midwife or GP can give you advice about improving your health while pregnant. Eating healthily and activities such as walking and swimming are good for all pregnant women. If you were not active before becoming pregnant, you should consult your midwife or doctor before starting a new exercise programme while you're pregnant.
Protect yourself against infection
Around 10% of stillbirths are caused by infection. Infections such as listeria, salmonella, and toxoplasmosis increase the risk of stillbirth for instance. Eating certain foods such as some types of fish or cheese can increase your risk of being exposed to such infections. Ask for information from your midwife about what foods and activities to avoid during pregnancy.
For more information on pregnancy infections visit NHS choices.
It is important to remember that the majority of pregnancies and births are free from problems but it is good to be informed and if you have any concerns speak to your midwife.
Your baby's health
Go to all your antenatal appointments
It is important to keep in regular contact with your midwives and doctor and go to all your antenatal check-ups. They will monitor the progress of your pregnancy and if there are problems they can make sure you get the care you need.
Urine and blood tests, along with regular blood pressure monitoring and ultrasound scans can pick up early signs of medical conditions that might affect your baby.
Regular measurement of your baby's growth can tell your midwife (and you) about your baby's progress. Poor growth can indicate problems and it is important this is picked up. A baby not growing well is at risk of stillbirth.
Be aware of your baby's movements
You will usually start feeling some movement between weeks 16 and 20 of your pregnancy, although it can be later than this. These movements may be felt as a kick, flutter, swish or roll.
The number of movements tends to increase until 32 weeks of pregnancy and then stays about the same, although the type of movement may change as you get nearer to your due date
You should continue to feel your baby move up to and during labour.
If you notice your baby is moving less than usual or if you have noticed a change in the pattern of movements, it may be the first sign that your baby is unwell and therefore it is essential that you contact your midwife or local maternity unit immediately so that your baby’s wellbeing can be assessed.
There is no specific number of movements that is normal. What is important is noticing and telling your midwife about any reduction or change in your baby’s normal movements.
If you feel your baby is moving less than normal, call your midwife or maternity unit. Don't wait for your next appointment.
For more information, see the leaflet on Your baby's movements in pregnancy produced by the Royal College of Obstetricians and Gynaecologists (RCOG).
Report any abdominal pain or bleeding.
If you have pain or tenderness in your abdominal area you should contact your doctor or midwife. Acute pain, high fever or vaginal bleeding should be reported immediately. It is better to report any pain that worries you sooner rather than later.
Higher risk groups
Most pregnancies and births are problem free but every baby is to some degree at risk and stillbirths are more frequent among the following groups:
- Twin or multiple pregnancies
- Older mothers i.e. aged 35 years+
- Teenage mothers
- Women with specific medical conditions, especially diabetes, hypertension and thrombophilia
- Women with a past obstetric history of complications
- Women who smoke
- Women who are obese i.e. a body mass index (BMI) over 30
- Women living in areas of social deprivation
- Women from some ethnic minority groups
Your midwife can give you information about your personal circumstance. The vast majority of women in these groups still give birth to a healthy baby
Poor growth in pregnancy
What do we mean by poor growth?
Midwives check the growth and wellbeing of your baby at every antenatal appointment. They use a tape measure to work out the distance from the pubic bone to the top of the womb. They should plot your baby’s growth on a chart to ensure he or she is continuing to grow.
Every baby is different and should grow to a size that’s normal for him or her. Some babies are naturally small, usually because their mothers are small. But all babies should continue to grow steadily throughout the pregnancy.
If a baby seems to be smaller than he or she should be, or the growth pattern tails off as the pregnancy continues, this is described as ‘growth restriction’, being ‘small for gestational age’ or not reaching his or her ‘growth potential’.
If a baby does not reach his or her growth potential in the womb this may be because the placenta is not working properly. This increases the risk of stillbirth.
Problems with a baby’s growth should be picked up during antenatal appointments.
It’s important also to be aware of your baby’s movements. Being aware of the patterns of movements may help in spotting any problems as early as possible.
Raising awareness of risks
“As a pregnant woman, how can I contribute to the management of my own care if I don’t know the risks?” Mum
Although most pregnancies are free of problems, some babies do die before or soon after birth.
Parents who have experienced this loss often say they had no idea that babies sometimes die and wish they had known it was a possibility. They might have acted differently if they had known there was any risk.
Many people think stillbirth is a thing of the past. That increases the risk of missing warning signs that something is wrong.
At Sands we think mothers should have access to information about stillbirth and the possible warning signs if something is not right.