A stillbirth is the loss of a baby at 20 weeks of pregnancy or later. In the United States, about 21,000 babies are stillborn each year, affecting roughly 1 in 175 births. The term distinguishes these losses from miscarriages, which occur before 20 weeks. If the gestational age isn’t known, a birth weight of 350 grams or more is used as the threshold.
Types of Stillbirth by Gestational Age
Stillbirths are classified into three categories based on when they occur. An early stillbirth happens between 20 and 27 weeks of pregnancy. A late stillbirth occurs between 28 and 36 weeks. A term stillbirth happens at 37 weeks or later. These distinctions matter because the causes, risk factors, and medical approach can differ depending on timing.
What Causes Stillbirth
Stillbirth can result from problems with the placenta, infections, genetic abnormalities, or conditions in the mother’s health. The placenta is the organ that delivers oxygen and nutrients to the baby, and when it fails to function properly, the baby may not survive. Problems like placental abruption, where the placenta separates from the uterine wall too early, are among the more common causes.
Infections account for 10 to 24 percent of all stillbirths in the United States. These infections can harm the baby directly, damage the placenta, or cause severe illness in the mother. Some infections are bacterial, others viral, and many are treatable if caught early.
Chronic health conditions in the mother also raise the risk. High blood pressure, diabetes, blood clotting disorders, and obesity are all associated with higher stillbirth rates. Being over age 35, carrying multiples, and having a history of pregnancy complications are additional risk factors. Smoking and substance use during pregnancy increase risk as well.
Despite thorough testing, a significant number of stillbirths have no identifiable cause. This is one of the most difficult realities families face.
Warning Signs to Watch For
The most important warning sign is a change in your baby’s movement. There’s no specific number of kicks or rolls that qualifies as “normal,” but what matters is a noticeable decrease or complete stop in your baby’s usual activity. If your baby has been active at certain times of day and that pattern changes, that’s worth paying attention to right away.
Severe belly pain that comes on suddenly and doesn’t go away is another warning sign. This includes sharp, stabbing, or cramp-like pain that worsens over time. Severe pain in the chest, shoulder, or back during pregnancy also warrants immediate medical attention.
How Stillbirth Is Diagnosed
Before delivery, the only way to confirm a stillbirth is to check whether the baby’s heart is still beating. This is typically done with an ultrasound, which uses sound waves to create an image and detect cardiac activity. If no heartbeat is found, the provider will confirm the diagnosis.
After delivery, medical staff look for specific signs of life: breathing, a heartbeat, pulsations in the umbilical cord, and voluntary movements. If none of these are present, resuscitation is attempted. When those efforts are unsuccessful, the loss is formally diagnosed as a stillbirth.
What Happens After a Stillbirth
After a stillbirth is confirmed, labor is usually induced so the mother can deliver vaginally. This can feel overwhelming, but it is the standard medical approach for most stillbirths. The process may take several hours to a full day or more, depending on the circumstances.
One of the most valuable steps after delivery is a placental examination, which provides useful information in about 65 percent of cases. Fetal autopsy, when families consent to it, identifies a cause of death in roughly 40 percent of cases. Together, these are the two most informative tests available. Genetic testing can also offer answers, particularly when chromosomal abnormalities are suspected. Medical teams typically frame these evaluations as a continuation of care for the baby, not a clinical formality, and families are always given the choice of whether to proceed.
Bereavement Care in the Hospital
Hospitals that follow current bereavement guidelines offer parents the option to see and hold their baby after delivery. This is a deeply personal decision, and there is no right or wrong choice. Staff will use compassionate language, referring to the baby by name when one has been chosen, and they’ll give families as much time as they need.
Memory-making is a central part of hospital bereavement care. Parents may be offered photographs, hand or footprints, a lock of hair, the baby’s blanket, an identification band, or a hospital birth certificate. These items are often presented in a special keepsake box. Because grief can make it hard to think clearly in the moment, many hospitals store mementos for up to a year in case parents aren’t ready to take them home at discharge.
Support typically involves a team that includes nurses, social workers, and chaplains or spiritual care providers. Cultural and religious needs are taken into account, and staff can help arrange memorial services, funerals, burials, or cremation. After discharge, hospitals often provide referrals to grief counseling, peer support groups, and follow-up appointments to check on both physical recovery and emotional wellbeing. Some facilities also take steps to prevent baby-related promotional mailings from reaching bereaved families and will acknowledge the anniversary of the loss.
Grief After Stillbirth
Losing a baby to stillbirth is a profound grief that affects both parents, siblings, grandparents, and close friends. There is no timeline for this kind of loss. Some parents find that talking about their baby helps. Others need time before they can. Both responses are normal, and they can shift from day to day.
Partners often grieve differently from each other, which can create tension at a time when support feels most needed. Perinatal loss support groups, both in person and online, connect families with others who have been through a similar experience. Many parents find these communities to be among the most helpful resources in the months and years that follow.