What happens after stillbirth
What should a woman expect, once a diagnosis of fetal death has been established?
This is usually a very difficult time. There is an initial explanation and counseling is offered. Ideally, the mother should have her partner or another person who is close to her with her. Plans of delivery will be discussed and normally this will be vaginal unless there is a contraindication to this, where a caesarean section may have to be undertaken.
The process of investigating the cause of death may begin soon after the diagnosis. This may be in the form of amniocentesis (taking fluid from around the baby). This is done early to maximize the chance of successfully culturing the fetal cells. This is to investigate possible chromosomal abnormalities. Other (blood) tests will normally be deferred until later.
Options will normally be given as to the time and day of labour induction and some mothers opt to go home first for a day or two before being admitted for induction of labour.
What about a postmortem examination (autopsy)?
Unless the cause of fetal death is definitely known, the parents will be advised to have a post-mortem examination done on the baby. This quite often comes up with an explanation for cause of death.
Is breast-milk produced, in spite of stillbirth?
Yes. The extent of milk production will depend largely on how advanced the pregnancy was. If the baby is lost late in the third trimester, there is full lactation and breast engorgement is a problem which will need to be addressed. This could be conservatively managed or medication can be given over a course of two weeks, sometimes longer, to suppress lactation.
What happens to the baby?
It is believed to be a good idea to encourage the mother to hold her baby. Pictures will be taken and if the mother does not want them immediately, they will be kept safe in case she changes her mind later. If, a few months after the event, she still does not want them, then they may be destroyed.
The parents are also encouraged to name the child. A discussion with parents is held on the subject of the kind of ceremony they would want for disposal of the baby's body. They may opt for a formal funeral or probably cremation.
Of-course this part of the process is largely influenced by cultural and personal views and may differ widely for different people in different communities.
So what follows for the parents?
Most hospitals have dedicated counselors to deal with such a situation. In the immediate aftermath, a counselor will be available to explain things and answer questions. On discharge from hospital, the parents will normally be put in touch with the various support groups within their locality.
An appointment to see their obstetrician will be made, usually within six to twelve weeks. It is at this visit that the parents will have an opportunity to know the results of the various tests and to have their many questions answered.