The loss of a baby is never easy, regardless of how far along you are. All parents want is to bring home a healthy baby at the end of the pregnancy. For some, dealing with a pregnancy loss does not even cross their minds until they become the unfortunate victims of it. During this difficult time, there can be a lot of confusion between the terms “stillborn” and “miscarriage.” Many people outside of the loss community tend to use them interchangeably, but they actually have different meanings. In this blog post, we will discuss the difference between stillborn and miscarriage. We will also talk about the symptoms of each and what you can do if you think you might be experiencing one. Always check with your doctor if you have any questions or concerns.
The difference between a miscarriage and a stillbirth comes down to the weeks gestation the loss occurs during a woman’s pregnancy. A miscarriage occurs before 20 weeks of pregnancy and a stillbirth occurs after the 20th week of pregnancy. The risk of stillbirth is lower than the risk of miscarriage, though both kinds of pregnancy loss affect many families across the world each year. A loss in the first trimester and partially into the second trimester is considered a miscarriage. A loss in the second half of the second trimester or in the third trimester is considered a stillbirth. The risk of fetal death goes down the further you go into pregnancy, but it never completely goes away. If your baby is born with a heartbeat and then passes afterwards, this is known as a neonatal loss.
This post does not give medical advice. If you ever feel you are experiencing the symptoms of a pregnancy loss, seek immediate medical attention from your doctor or healthcare provider.
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What is a Miscarriage?
A miscarriage is medically classified as the loss of a pregnancy before the 20th week of pregnancy. Miscarriages are, unfortunately, very common and in the United States, it is estimated that one in four pregnancies ends in a miscarriage. Though it is a common occurrence, it is a heartbreaking experience. If you or someone you know has experienced a miscarriage, it is important to seek out support. This can be with family, friends, a health care provider, or other women you know that have experienced loss. The people closest to you play an important role in helping you heal after loss, so rely on them when you need them. Speaking with other women or families that have gone through pregnancy loss can help you feel more understood and help you process your grief.
Most occur during the early weeks of pregnancy during the first trimester. This can happen for a variety of reasons, but the most common cause is an abnormality in the fetus. The American College of Obstetricians and Gynecologists estimates that around 50% of all early pregnancy losses are due to chromosomal issues. Other causes can include bacterial infections, medical conditions of the mother, hormonal imbalances, or a genetic disorder.
An ectopic pregnancy is sometimes classified by the medical community as a type of miscarriage as well. This is an early pregnancy loss where the egg implants outside of the uterus. This can be life-threatening to the mother and requires quick medical action by your doctor. If you suspect you are having an ectopic pregnancy, get in to see doctor or healthcare provider immediately.
A chemical pregnancy is a loss that occurs within the first five weeks of gestational age during pregnancy. The fertilized egg either implants and then the loss occurs, or it may not implant at all. It can be hard to estimate the number of babies lost due to chemical pregnancies. Many of these losses occur before the woman even knows she is pregnant. They can also occur shortly after a woman gets a positive pregnancy test.
Sometimes doctors use terms like “spontaneous abortion” to describe a miscarriage. The term can be abrasive and unexpected. This is the medical term that some doctors use to describe an early pregnancy loss. Make sure you speak up if you are uncomfortable with them using the term when speaking with you. They may still list the term in your medical records, but at least you will not have to deal with the emotions that can sometimes come with unexpectedly hearing this term.
Symptoms and Signs of a Miscarriage
There are a few different signs and symptoms of a miscarriage. The most common symptom is vaginal bleeding or spotting. This can range from light spotting to heavy bleeding, and it may or may not be accompanied by clotting. Other symptoms can include cramping in the lower abdomen, back pain, or tiredness. Some miscarriages, known as a missed miscarriage, do not have any symptoms at all. A missed miscarriage is usually detected when you go in for a routine check with your healthcare provider.
What Happens if I Experience a Miscarriage?
If you experience a miscarriage, there are a few different things that can happen. If you have already miscarried and the baby has passed, your healthcare provider will likely just monitor you for any complications. You will want to make sure they continue to monitor your HCG pregnancy hormone levels to make sure they come down to the appropriate level.
If the baby has not yet passed, they may recommend either waiting for it to pass on its own or having a D&C procedure. This is a surgical procedure where they dilate the cervix and remove any remaining tissue. Sometimes you will be given a choice of taking a pill to help your body miscarry or to go through the surgery option of a D&C. This is a personal decision you must make with your partner or family. There is no right or wrong decision.
After a miscarriage, you may be told to wait a cycle or two before you try to get pregnant again. You may also be told you do not have to wait and can try again right away. Even if your body is physically ready, you may not be emotionally ready right away. Make sure you give yourself the time you need to heal before trying to get pregnant again.
What is a Stillbirth?
The term stillbirth refers to the loss of a pregnancy after 20 weeks of gestation. According to the March of Dimes, the rate of stillbirths is 1 in 160 pregnancies each year in the United States. The Centers for Disease Control and Prevention, estimates there are 24,000 stillborn babies in the U.S. each year. The causes of stillbirth can be due to a number of factors, including placental problems (like a placental abruption), umbilical cord problems, chromosomal problems, an infection, or other medical reasons. Stillbirth is more rare than miscarriage, though it still affects many families each year. An early stillbirth would be in the second trimester, while a later stillbirth would occur during the third trimester.
If your baby is born with a heartbeat and dies shortly after, this is not considered a stillbirth. This type of loss is known as a neonatal loss or neonatal death. This same term applies to a preterm birth baby who is born alive and then passes away shortly after.
Stillborn babies do not receive either a birth certificate or a death certificate. Some states offer a certificate of stillbirth, so be sure to ask your hospital or doctor if this is available to you. This can be an important item for families who want a keepsake or something to help acknowledge their baby’s existence. They are not considered live births because the baby was not born with a heartbeat. Even though they are not medically recognized as a living person, these babies are very real people. Do not let the medical community make you feel as though your baby does not matter or is not a real person.
Symptoms and Signs of Stillbirth
The most common symptom of a stillbirth is the sudden absence of fetal movement. Reduced movement can be difficult to detect, especially if you are not used to feeling your baby move. Other symptoms can include bleeding, cramping, or even irregular movement. If you notice any of these changes, it is important to contact your doctor right away to get an ultrasound or other medical check. Your doctor can perform an ultrasound to check for signs of life, like a heartbeat.
You can sometimes be at a higher risk of your baby being stillborn if you are an older mother, smoke, or use drugs. If you have any of these risk factors, it is important to discuss it with your healthcare provider.
What Happens if I Experience a Stillbirth?
If you experience a stillbirth, you will most likely deliver your baby vaginally. In some cases, a cesarean section (C-section) may be necessary. After delivery, you will be able to hold and spend time with your baby if you wish. You may also have the option to take pictures with your baby and have hand and footprint molds done.
Make sure you contact Now I Lay Me Down to Sleep if you would like pictures. They are a volunteer organization that comes in to take pictures for families experiencing loss. Even if you think you do not want pictures, take some. You may not be able to look at them right away, but you may regret not having them later. Ask your hospital if you can have a private room in which to grieve, if they do not offer one. Spend as much time as you need with your baby, making as many memories with them as you can.
Having a stillbirth will not usually affect your chances of getting pregnant again. It may take a couple of months, or longer, for your menstrual cycle to regulate again. After this type of loss, you may have to wait six months to a year before trying again. The medical professionals you see, like your OBGYN, midwife, or MFM, may consider you high risk during your next pregnancy and keep a closer eye on your medical care. Though you may want to get pregnant right away, your body needs time to heal, especially if you had a late stillbirth and were futher along. You may also want to consider talking with a counselor or therapist to help you deal with your grief. There are also a variety of both in-person and online support groups that can help you process your grief after the death of a baby.
You can request that a doctor perform an autopsy or genetic testing on your baby to see if they can determine a cause. If you know the cause of the stillbirth, you can sometimes take certain medications or actions to avoid it happening again. Unfortunately, some losses will be classified as an unexplained stillbirth and have no known cause. If the cause of stillbirth is unknown or is something that does not have preventative actions you can take, make sure to ask for additional monitoring during any future pregnancies. By keeping a close eye on the next pregnancy, hopefully you can avoid any more pregnancy losses.
How Can I Avoid Having a Pregnancy Loss?
There are some things you can do to help reduce your risk of having a pregnancy loss. First, make sure you are getting good prenatal care and following all of your provider’s recommendations. You should also take steps to manage any chronic health conditions you have, like diabetes mellitus or high blood pressure. If you smoke cigarettes or recreational drugs, or have other illicit drug use, now is the time to stop. You should also take a prenatal vitamin with folic acid, which can help reduce the risk of some birth defects.
Take care of your mental health and make sure you are receiving good emotional support from your partner or other family members. Managing stress during pregnancy can be difficult, but there are some things that can help. It may be helpful to speak with a counselor about your stressors and join a support group for mothers-to-be. Exercise and relaxation techniques like yoga or meditation can also help reduce stress levels.
If you have known risk factors, like a previous stillbirth or pregnancy loss, your provider may recommend additional steps to help reduce your risk. These may include things like more frequent prenatal visits, special tests during pregnancy, or medication to help improve blood flow to the uterus. Taking these steps can help give you peace of mind and make sure you are doing everything possible to have a healthy pregnancy and baby.
Sometimes, you may have a pregnancy loss due to an unknown cause. In cases like this, it can be extremely frustrating to not know why it happened. There is a doctor, named Harvey Kliman, who specializes in the pathology of the placenta. You can contact him to send slides of your placenta and do a systematic review of the placenta to see if he can determine the cause of your loss. Kliman has successfully helped many families figure out the cause of their loss, even when the cause was previously unknown. Though knowing a cause does not make the death of your baby any easier, it can at least possibly help you prevent another loss in the future.
Going through any type of pregnancy loss, whether it is a miscarriage or a stillbirth, is a hard experience both physically and emotionally. It does not matter how far along you are, as soon as you join the other pregnant women in celebrating your pregnancy, you start to have hopes and dreams for your baby. Recognizing the signs and having early medical intervention is important to help reduce your risk, though it cannot eliminate losses from occurring.
It is important to give yourself time to grieve and heal before trying to conceive again. There are many support groups available, both online and in person, that can help you through this tough time. If you want to try for another baby right away, make sure you talk to your provider first about any steps you can take to help reduce your risk. No matter what you decide to do, know that you are not alone in this experience. There is support available to help you through it.
You may also be interested in:
Miscarriage Kit: What To Pack for Comfort After Pregnancy Loss
Does Bleeding Mean Miscarriage? (Early Signs & Symptoms)
Free Gifts for Miscarriage and Pregnancy Loss: Items of Remembrance
Comforting Bible Verses for Miscarriage & Pregnancy Loss (Healing Scriptures)
Miscarriage Keepsake Jewelry (Gift Ideas for Loss of Baby)
How to Advocate for Yourself with Doctors After a Pregnancy Loss