Top things to know about recovery after a stillbirth
Stillbirth is not your fault.
There is no “right way” to feel emotionally.
Your body will take time to heal.
Medical conditions, the way your pregnancy ended, and the gestational age of your pregnancy all make your experience unique to you.
Your body will go through the postpartum process after a stillbirth.
It’s important to consult a maternal fetal medicine (MFM) specialist before your next pregnancy.
Pregnancy loss at any stage can be difficult to experience. Most people experience grief, but some people have other reactions. All feelings are valid. Physical and emotional healing after stillbirth varies widely between people, communities, and cultures. This article will help you understand what to expect after stillbirth, provide some insights into healing, and offer useful advice for future pregnancies.
Dr. Moayedi says: Contact your healthcare provider or seek help immediately if at any point after your stillbirth you are soaking more than 4 pads in 2 hours; you are having intense pain your medications cannot control; you have a fever over 100.4 F/ 38 C; you faint or lose consciousness, or you feel severe emotional distress, like intense hopelessness or sadness.
What is the difference between miscarriage and stillbirth?
Pregnancy loss prior to 20 weeks is typically called miscarriage, whereas loss after 20 weeks is called stillbirth (1). People experience both stillbirth and miscarriage for a variety of reasons, none of which are the fault of the pregnant person. A cause for stillbirth often cannot be found, even with testing (2).
If you have experienced a stillbirth recently, we are so sorry for your loss. It’s not your fault, there is nothing you could have done to stop it, and you are not alone. Almost two million stillbirths occur around the world every year. One out of every 160 births in the United States ends in stillbirth (2, 3).
Your emotional recovery after stillbirth is just as important as your physical recovery.
Whatever you are feeling after stillbirth is valid. There is not one “right way” to process grief or to emotionally recover after stillbirth. Parents across the world report complex emotions, expressions of grief, and in some contexts, feelings and experiences of stigmatization in the weeks, months, and even years after stillbirth (4).
Parents recovering from stillbirth report experiencing fear, panic, depression, thoughts of suicide, anxiety, or post-traumatic stress disorder more often than parents who took home an infant after a birth (5). While many factors can contribute to difficult feelings after stillbirth, counseling, support groups, exercise, and sex help some parents with their emotional recovery (4, 5).
For some people, spending time with their baby, taking photographs, having a ritual, or making keepsakes with footprints or locks of hair are critical for the grieving process. However, know that you can do whatever feels right and helpful for you. The team at Clue understands how difficult this time can be and we want to extend our support to you.
How might the body physically feel after stillbirth and what does it need?
Physical recovery after a stillbirth depends on your unique medical conditions, how long your pregnancy lasted, and the way your pregnancy ended. After a fetus dies, birth can happen spontaneously (without medical help) through vaginal birth, or with the help of medications, in a process called labor induction. Pregnancy tissue removal could also require a procedure called dilation and evacuation (D&E) or, in rare cases, a cesarean section (1,2). If a stillbirth happens in the setting of other significant medical conditions, like an infection or severe diabetes, physical recovery will also depend on treating those conditions (2).
Many people experience cramping, bleeding, and passage of blood clots for a couple weeks to a couple of months after stillbirth. Cramping can usually be managed with medications like ibuprofen and a heating pad. If the bleeding results in completely soaking more than two pads an hour for two hours straight, contact a healthcare provider. Most people can move their bodies without major discomfort a few days to a few weeks after a vaginal birth or D&E. Physical recovery after c-section for stillbirth is identical to recovery after c-section in other circumstances and might take two to three months (2, 6).
Milk production, known as lactation, breast/chest engorgement, or milk leakage are part of the routine postpartum process, even after stillbirth (7). Lactation can have a complex impact on grieving parents (7). Without nipple stimulation, lactation will eventually stop on its own after stillbirth. However, some engorgement or milk leakage might still occur before production stops (8). Some people choose to express and donate their milk as part of their emotional recovery (7). For your comfort, you can apply ice packs several times a day or wear a tight fitting bra to help stop lactation without any medication (8).
Your healthcare provider might also be able to prescribe medications that can help stop milk production (8). If you notice any fever, severe breast/chest tenderness, or your breasts/chest turn red, call your healthcare provider right away as this could indicate an infection called mastitis.
Having sex again, becoming pregnant again, or preventing pregnancy after stillbirth
Some parents report emotional difficulty returning to sex after stillbirth, but others find it therapeutic and part of their emotional recovery (4). You can return to having sex after stillbirth when you feel physically and emotionally ready. Talk to your healthcare provider if you aren’t sure if you’re physically ready to return to having sex.
Typically, you can become pregnant again after a stillbirth whenever you feel emotionally ready to be pregnant again. That said, there are a number of causes for stillbirth and unfortunately, a person who has had a stillbirth has an increased risk of having another one (2). It’s important to have a consultation with a healthcare provider like a Maternal-Fetal Medicine (MFM) specialist before the next pregnancy to identify any possible risk factors and plan any specialized care for the next pregnancy (2). If you are in the US, you can find an MFM specialist in your area here.
Pregnancy care after stillbirth includes checking in on your body and your fetus more often than a previous pregnancy. Continue taking your prenatal vitamins after stillbirth, until you have decided if you want to be pregnant again or not.
If you don't want to be pregnant again immediately after a stillbirth, there are lots of birth control options to help you avoid pregnancy until you’re ready – if indeed you want to become pregnant at all. Progestin-only pills and subdermal implants can be started immediately after a stillbirth at any stage (9). After stillbirth in the second trimester, most people can safely start estrogen containing birth control pills, patches, rings, or injections (10).
The risk of developing a blood clot remains high after third trimester stillbirth. Avoid estrogen-containing birth control methods for a minimum of 21 days after a third-trimester stillbirth (9). If you want an estrogen containing pill, patch, ring, or injection after stillbirth, talk to your healthcare provider to see when estrogen is safe for you to take.
When stillbirth occurs with a severe infection of the uterus or sepsis, IUD insertion should be delayed by several weeks (9). Otherwise, an IUD can be placed immediately after delivery or at any time in the weeks following stillbirth.
If you’ve recently experienced stillbirth, here are some resources that might be helpful: