Talking about stillbirth can feel frightening. Clear information should help you know what to do and where to get support, without making you feel responsible for everything that happens in pregnancy.
Some steps can lower the chance of stillbirth, but no checklist can prevent every loss. Stillbirth can happen despite careful pregnancy care. If you have lost a baby, these recommendations are not a way to judge what you did or did not do.
If your baby is moving less, movements feel weaker, movements have stopped, or their usual pattern has changed in a way that worries you, contact your maternity unit or midwife immediately, day or night. Do not wait for tomorrow or your next appointment. If you cannot reach your maternity team, go to the nearest hospital for urgent assessment.
What does stillbirth mean?
In Australia, stillbirth means a baby is born without signs of life at 20 weeks of pregnancy or later, or weighs at least 400 grams. A baby may die during pregnancy or during birth. The causes vary, and sometimes investigations do not find a clear explanation.
The following four areas bring together practical steps and the care your maternity team provides. Your own plan may include extra monitoring because of your health, your baby’s growth or a previous pregnancy experience.
1. Get to know your baby’s movements and act on changes
Most people first notice movement between 16 and 24 weeks. As movements become familiar, pay attention to your baby’s own pattern and strength. There is no single number of kicks that is right for every baby. If you have not felt any movement by 24 weeks, contact your midwife or doctor.
Your baby should continue moving as you approach your due date and during labour. The way movements feel may change, but moving less should not be explained away as your baby running out of room.
If you are concerned:
- Call straight away, even if you have been checked before and everything was fine.
- Do not delay the call to try a cold drink, something sweet or a home movement-counting test.
- Do not use a home Doppler or phone app to decide whether your baby is well.
- Keep the assessment plan your team gives you, even if you notice some movement while waiting.
Hiccups do not replace your baby’s usual movements or rule out a problem. Our guide to fetal hiccups and movement concerns explains the distinction.
2. Start each sleep on your side from 28 weeks
From 28 weeks, settle to sleep on either your left or right side. This includes daytime naps and going back to sleep during the night. Side going-to-sleep position is associated with a lower risk of late stillbirth than going to sleep on your back.
If you wake on your back, simply roll onto your side before settling again. You do not need to stay awake checking your position. A pillow behind your back or between your knees may help you feel comfortable; a special pregnancy pillow is not essential. Ask your care team for help if pain or another condition makes side sleeping difficult.
3. Get support to stop smoking
Smoking increases pregnancy risks, including stillbirth. Stopping at any stage can help, and you deserve practical support rather than judgement. Tell your midwife or doctor if you smoke, vape or are finding it hard to stop. They can help you choose a quitting plan and discuss which treatments are appropriate during pregnancy. E-cigarettes are not recommended in pregnancy.
People around you can help by keeping your home and car smoke-free and supporting your quit plan. The Australian Safer Baby smoking information includes links to support.
4. Make a shared plan for growth checks and timing of birth
At antenatal appointments, your team checks your health and your baby’s growth. Growth may be monitored through measurements of your abdomen and, when needed, ultrasound. A baby growing more slowly than expected may need closer assessment.
Let your team know if cost, travel, work, language or caring responsibilities make appointments difficult. Ask what support or alternative arrangements are available rather than trying to manage a missed check on your own.
If there are concerns about your health or your baby, a planned earlier birth may be recommended. The decision should balance the risks of continuing the pregnancy with those of being born earlier. It does not mean everyone needs an early induction.
Useful questions include:
- What is the concern in my pregnancy, and how certain are we?
- What are the benefits and risks of waiting or planning birth now?
- What monitoring would I need if I wait?
- Who should I contact if something changes?
Our induction of labour guide explains what a planned induction can involve.
You do not have to manage worry alone
If these conversations bring up fear or a previous loss, tell your midwife or doctor. Ask for extra time, a support person or a referral for emotional support. You can ask for information to be explained again, in smaller steps or with an interpreter.
Save your maternity unit’s 24-hour number in your phone. A concern about movements is enough reason to call; you do not need to prove that something is wrong.
Sources and further reading
- Australian Commission on Safety and Quality in Health Care: Stillbirth Clinical Care Standard
- Safer Baby: Your baby’s movements matter
- Safer Baby: Sleep on your side
- Safer Baby: Your baby’s growth matters
- Safer Baby: Timing of birth
This is general information for Australian readers. Your maternity team can advise on your pregnancy and any symptoms that need assessment.