Stillbirth is when a baby dies before she or he is born, after 24 weeks of pregnancy. In England, around 1 in 250 births is a stillbirth.
Not all the causes of stillbirth are currently known and 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 and scans
It's important not to miss any of your antenatal appointments or scans. 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 do not need to put on any extra kilos in pregnancy if you're already overweight.
Read about:
- how to have a healthy diet in pregnancy, including healthy snacks
- exercise in pregnancy
Stop smoking
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 is not 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.
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. Do not worry if you wake up on your back, just turn on to your side to go back to sleep.
Find out about sleep position in pregnancy on the Tommy's website
Tell your midwife about any drug use
Using illegal drugs during pregnancy could harm your baby. If you use or have used illegal drugs (such as cannabis, cocaine, ecstasy or heroin) or other substances, tell your midwife or doctor.
The more your midwife knows about your general health, the better she or he will be able to help you and your baby.
Do not 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.
Have the flu jab
Make sure you have the seasonal flu vaccination, which is available from early autumn 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 signs of infectious illnesses, including diarrhoea, high temperature and being sick (vomiting).
You should also avoid children (as well as adults) who have been diagnosed with "childhood illnesses" (infections most common in childhood) like chickenpox, measles, or parvovirus (slapped cheek syndrome).
If you have been or are in contact with someone with an infection, speak to your midwife or GP for advice.
Find out about infections in pregnancy that may affect your baby
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.
- Wash fruit, vegetables and salads to remove all traces of soil, which may contain toxoplasma (a parasite that can cause toxoplasmosis) which can harm your unborn baby.
- Wash all surfaces and utensils, and your hands, after preparing raw foods (meat, eggs, fish, shellfish and raw vegetables) to help you avoid food poisoning.
- Make sure that raw foods are stored separately from ready-to-eat foods, otherwise there's a risk of contamination.
- Use a separate knife and chopping board for raw meats.
- Heat ready meals until they're steaming hot all the way through – this is especially important for meals containing poultry.
- Check the use-by date to make sure food is safe to eat – do not eat food after the use-by date even if it looks and smells OK.
You also need to make sure that some foods, such as eggs, poultry, burgers, sausages and whole cuts of meat like lamb, beef, chicken, and pork, are cooked very thoroughly until steaming all the way through.
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. This includes raw or undercooked meat, some cheeses, and unpasteurised milk.
You should also avoid caffeine or limit it to no more than 200mg a day. Caffeine is in foods and drinks such as coffee, tea, energy drinks, cola and chocolate.
Get to know which foods to avoid while you're pregnant.
When to get medical help
Urgent advice: Contact your maternity unit or call 111 immediately if:
- your baby's movements have reduced, changed or stopped
- you have bleeding from your vagina
- you have stomach (abdominal) pain
- you have unusual vaginal discharge or fluid
- you have swelling, blurred vision or severe headache
- you have itching anywhere on your body, possibly worse at night
Your baby's movements have reduced
Call your midwife or maternity unit straight away if:
- your baby is moving less than usual
- you cannot feel your baby moving anymore
- there is a change to your baby's usual pattern of movements
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 (such as a 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 does not mean your baby is well.
Find out more about baby movements in pregnancy on the Tommy's website
You bleed from your vagina
Vaginal bleeding 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 or fluid from your 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 or swelling
Blurred vision, severe headache and swelling could be signs of pre-eclampsia. Although pre-eclampsia is often mild, in some pregnancies it can lead to life-threatening problems for both mother and baby.
Symptoms of pre-eclampsia include:
- sudden swelling – especially of the feet, ankles, hands and face
- severe headache that does not go away with painkillers
- vomiting
- problems with vision, such as blurring or seeing flashing lights
- severe pain just below the ribs
- heartburn that does not go away with antacids
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.
Find out about itching and intrahepatic cholestasis of pregnancy (obstetric cholestasis)