If the unthinkable has happened and you have been told that your baby has died in the womb before labour has started, the options for giving birth will be raised with you.
It is likely to be very difficult to process anything you are told at this point because of the overwhelming shock of being told your baby has died. It can be helpful to ask another person – such as a parent or friend – as well as your partner, to be with you while you talk to doctors and midwives about the next steps.
If there's no medical reason for the baby to be born straight away, it may be possible to wait for labour to start naturally. You might not need to decide immediately. It may be possible to go home for a day or two first.
Legally, it is the mother’s decision how she decides to give birth to her baby. This information is, therefore, directed at mums but we hope dads and partners will find it useful too.
Vaginal birth or caesarean section?
Your options will depend on the circumstances, for example if you have a condition such as pre-eclampsia or you have an infection, it may be medically necessary to have caesarean section. This may have to happen quite quickly.
However, in most cases vaginal birth is safer for the mother than having a caesarean section so this is likely to be what the doctor will recommend. You will be asked if you would like your labour to be induced (started using medicine). This medication can take up to 48 hours, or in some cases significantly longer, to work.
"Our initial reaction when we were told that our son had died was that we wanted to have a caesarean section. The thought of giving birth to a dead baby was almost unbearable. But of course this wasn’t just a dead baby this was our precious son and I am so glad that I was persuaded to give birth to him naturally. I feel proud of going through that for him. I held him within a minute of being born, after the midwife had dried him a little and wrapped him in a blanket – what a wonderful feeling that was to finally meet him."
Kathryn, who lost her son Arthur at 36 weeks (taken with permission from the book, ‘Life After Stillbirth’ by Sarah Smith)
"There was a lot of information to process and part of me wanted the decision to be taken out of my hands… I felt an enormous burden to try and work out what to do in the midst of feeling so utterly devastated. Kate [midwife] was incredibly helpful at taking time to sit with us, listen to us and give us space to work it all out."
Lucy, who lost her son Jude at 41 weeks (Read Lucy’s story here)
Preparing for the birth
You may be offered the opportunity to go home to prepare for your birth. If you go home or get the chance to collect some things from home, ask your midwife about what you should bring. Hospitals can get very warm, so make sure you have cool clothes. You may also want to bring food and snacks to keep you going through labour.
You might also want to think about what to bring for your baby – perhaps a special babygro, or blanket, or a cuddly toy. If your baby is very premature, the hospital might be able to provide very small clothes, if you don’t have anything suitable.
Waiting to go into labour naturally
You may be given the option of waiting for labour to start naturally, rather than being induced.
Things to consider:
- You’ll need to have a blood test after 48 hours and then twice a week to check your health.
- If you haven’t gone into labour after two or three weeks, or there are concerns about your health, the doctors will advise an induction.
- As time goes by, your baby’s condition will deteriorate in the womb. If you decide to have a post-mortem, this may affect the results. It will also affect how your baby looks when he or she is born.
You can change your mind
If you decide to wait for labour to start naturally but then change your mind, that is absolutely fine. You will be making difficult decisions after receiving this devastating news. It’s completely understandable to change your mind and rethink decisions as the shock subsides and healthcare staff will not think you are 'being a nuisance', which is something women have told us they worry about.
If you go home before giving birth to your baby, the hospital will give you a contact number (if they do not, request one) so you can get in touch with any questions or concerns at any point.
You may be given some medication to help prepare your womb for giving birth. This can take up to 48 hours to take effect so you may need to go home during this time. Talk to your midwife if you’re unhappy about leaving hospital.
Labour is usually induced by swallowing a tablet or by inserting a gel or pessary into the vagina. Your midwife can tell you more about this.
It can take time for contractions to begin and they may be irregular at first.
As your cervix dilates, your contractions are likely to become more intense and regular.
If the pessary or tablets don’t bring on established labour, you may be given hormone medication through a drip in your arm and will need to stay in hospital. This is the next level of induction and should help your labour progress. Alternatively you will be given a chance to rest and the procedure will be started again after 24 hours.
"The midwives might leave you on your own during labour, but if you feel vulnerable or anxious and being left alone is making things more difficult for you, please talk to your midwife. Often staff leave parents because they feel they need privacy or are managing fine on their own. It’s all about communication."
Vicky, specialist bereavement midwife
There are lots of different ways to manage contractions yourself, including massage, movement, different positions and breathing techniques.
As labour progresses and contractions become more intense, you may want to use some pain relief.
Gas and oxygen (gas and air, Entonox)
This is a mixture of oxygen and nitrous oxide gas. You breathe ‘gas and air’ through a mouthpiece and it can take the edge off painful contractions but won’t remove the pain completely. Some people find it makes them feel sick, or sleepy, while others find it very relaxing. Gas and air is available in maternity and gynaecological units.
Pethidine or Diamorphine
Pethidine, or Diamorphine, is given by injection or through a drip, and can take the edge off the pain. It doesn’t numb you completely.
These medicines can make people feel drowsy or sick. Some mums find they can’t remember all of the birth – it becomes blurry or fuzzy – and you may feel drowsy afterwards.
This is a local anaesthetic injected into the spine. A very fine tube is inserted into your spine and remains there throughout the birth. You may be able to top up the epidural (by pressing a button on a machine).
An epidural removes most pain for the majority of women by numbing the nerves that carry the pain impulses from the birth canal to the brain.
You may need a catheter to empty your bladder. You’ll be monitored regularly and your blood pressure taken.
As with all effective pain relief there are some risks involved, which the anaesthetist will talk you through. For example, 1 in 100 people get a severe headache after having an epidural.
Who to bring with you to the birth
Having a partner, friend or relative as a birth partner to help you through labour can be a huge support.
You might choose to have more than one birth partner. This is helpful during a long induction.
Your birth partner will also be able to talk to you about the birth afterwards, and help if your memory is hazy or you struggle to piece together what happened.
"It’s amazing how nature kicks in, despite the devastating outcome, my body knew it had one job to do, to deliver a baby and even though I knew that this wasn’t one of those – ‘the pain will be worth it moments’ – I wanted my baby’s entry into the world to be one that was calm and peaceful, perhaps because this was the last thing I would be able to do for him as his mum."
Lucy, who lost her son Jude at 41 weeks (Read Lucy’s story here)
Doctors usually recommend a natural or induced labour to deliver your baby. This is because a Caesarean (or C-section) is a surgical procedure, which carries more risks to the mum and can affect future pregnancies. It usually requires a longer recovery period too. However, there may be reasons why you want to have a C-section. Discuss this with your doctor. They will be able to talk through the risks in more detail.
If you have a C-section, you’ll usually be given a spinal or epidural anaesthetic. This means your partner can be with you in the operating theatre and that you’ll be awake when your baby is born. It carries fewer risks and usually leads to a faster recovery.
A general anaesthetic puts you to sleep during the C-section, and may be needed in certain circumstances.
After the birth
Seeing your stillborn baby
If it is possible, discuss what’s going to happen straight after the birth with your midwife beforehand. You may want to see and hold your baby straight away. You may want the midwife to take him first. You might change your mind and this is fine. But having thought through it in advance will help.
"The midwives asked if I would like to see him but I was too frightened , something I will always regret. They asked if I’d like pictures, which I refused at first. If it wasn’t for the support of a very lovely midwife I could, in my mind, have made the biggest mistake of my life. Thankfully I changed my mind later that night."
Shelley, who lost her son Joseph at 37 weeks (Read Shelley's story here)
"Many parents tell us that they’re worried and anxious, sometimes frightened, about seeing their baby at birth. This is normal and understandable. It’s important to take the time to make the decision to see your baby. This should be supported by midwives, doctors, partners and extended family. Sometimes a couple may feel differently about seeing their baby and, again, that’s a normal reaction. Parents should be individually supported with the decision they make."
Vicky, specialist bereavement midwife
When your baby is born, you can ask your midwife to describe him to you. She could take a photo of your baby before you see him. Or you might decide together to just look and touch your baby’s hand and feet, while the rest of him stays covered.
"I had asked my lovely midwife, Tina, to look at him first as I didn't know what was for the best and as we didn't know when he had died I didn't know what to expect. She brought him to me, to us, and we were in love immediately with the perfect little boy that we never had the chance to meet. He was perfect-looking like a sleeping baby."
Sarah, who lost her son Tristan at 38 weeks (Read Sarah's story here)
"I didn't want to hold my baby Erin after she had been born but my husband did, which I totally respected. We also arranged for the hospital chaplain to bless her, which was beautiful. I later changed my mind however and went to the chapel of rest to hold her and completely broke down. I’m glad I now made that decision, but everyone will feel differently."
Bethan, who lost her daughter Erin
Your midwife can wrap your baby in a blanket for you to cover some of the deterioration. They can also place your baby in a Moses basket, or cot, in the room, so that you can choose when to see him.
Spending time with your baby after he’s born can be a precious time to create special memories and help you grieve. Your hospital may have a Cuddle Cot, which is a cot that keeps your baby cool. This slows down deterioration so that you can spend more time with him.
"Heidi, my angel was put straight into my arms while I lay on the operating table. She was perfect. She had dark hair, long fingers and big feet. She was beautiful. They took her away to clean her up and the next time I saw her she was dressed in a special Moses basket waiting for us. There are no words to describe how utterly lost you feel at that point. I needed to grieve. I needed to go into a quiet room and completely break down."
Rachel, who lost her daughter Heidi at 29 weeks (Read Rachel's story here)
Delivering the placenta
If you’ve been through labour, you’ll also need to give birth to the placenta. This is known as the third stage of labour.
You may be offered an injection of oxytocin in your thigh to help deliver your placenta. This is known as ‘active third stage’ and it is your choice.
It can be difficult at this point because you might just want to be left alone with your baby. However, the midwives need to continue caring for you until your placenta is delivered.
"After Rhianna was born all I wanted was everyone to go, to leave Mr L, and myself with our baby girl. I instantly wanted everyone out of the room, I no longer wanted anyone there and it was an overwhelming feeling it was so strong. They spent almost an hour in the room with us after Rhianna Lily was born, and it literally was tearing me apart."
Kerry, who lost her daughter Rhianna Lily at 24 weeks. (Read Kerry’s blog here)
If the placenta doesn’t come away from the womb or there are complications, you may be taken to theatre and given a spinal anaesthetic so your doctor can manually remove it.
Your baby can go with you to theatre. It might be possible for your partner to go too. Keep talking to the doctors about what is right for you.
If you decide to spend time with your baby after he’s born, we have put together some suggestions for things you can do, such as bathing and dressing your baby, and ways you can create memories.
We also have more information about what to expect in the next few days and weeks, including coping with the physical effects of the birth, such as your milk coming in and postnatal care.
If you are worried about the practicalities of what happens next, please read our section on the practical issues, such as registering your baby.