Preparing for labour and birth with a stillborn baby

It is devastating to find out that your baby has died before labour has started. If you are in this situation, your midwife or doctor will talk to you about the different options for giving birth. If you're alone in hospital, ask the staff if they can contact someone close to you to come in and be with you.

You may find it extremely difficult to process anything you are told at this point because of the overwhelming shock you are in. It can be helpful to ask another person – such as a parent or friend – as well as your partner, if you have one, to be with you while you talk to doctors and midwives about the next steps.

"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. Read Lucy’s story.

Legally, it is the mother/birthing person’s decision how they decide to give birth to their baby. Because of this, the information on this page is aimed at them, but we hope that dads, partners and birth partners will find it useful too. 

If there's no medical reason for your baby to be born straightaway, it may be possible to wait for labour to start naturally. You might not need to decide this immediately. You may be able to go home for a day or two first.

In some cases, you might be offered medicine to help induce labour. This can either be one medication or a combination of two medications. This might take up to 48 hours to work. 

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. Here are some suggestions:

• cool clothes (hospitals can get very warm)
• food, snacks and drinks to keep you going through labour
• home comforts such as a dressing gown, slippers and pyjamas
• big pants and maternity pads for the post-partum bleeding (this bleeding is much heavier than a period)
• breast pads
• things to relax you and make you feel more comfortable such as essential oils to smell or music to listen to.

Although it may be very difficult, try to think about anything you would like to bring for your baby. Perhaps a special babygrow, a 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. 
If you decide to wait, here are some 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 2 or 3 weeks, or there are concerns about your health, the doctors will advise that you have 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 they are 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 your decisions. Your healthcare team will not think you are 'being a nuisance', which is something parents have told us they worry about.

If you go home before giving birth to your baby, the hospital will give you a contact number so you can call them with any questions or concerns at any point. If they don’t give you a contact number, make sure to ask for one before you go home. 

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.

Choosing between a vaginal birth or caesarean section

In most cases, a vaginal birth is safer than a caesarean-section so this is probably what your doctor will recommend. But how you give birth is your decision and your options will depend on your circumstances. For example, a c-section section might be needed if:

• you have a condition where your health is at risk such as placental abruption or severe pre-eclampsia, 
• you have had a c-section or surgery on your womb previously
• the amniotic sac (fluid around the baby) has broken. 

The caesarean may have to happen quite quickly.

"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. Taken with permission from the book, ‘Life After Stillbirth’ by Sarah Smith.

Induced labour

If you’re offered an induction, you will be given 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 the hospital.

An induction may be done immediately if the health of the mum/birthing person is at risk. This might include if:

• you have severe pre-eclampsia
• you have a serious infection 
• the amniotic sac (the bag of water around the baby) has broken.  

Labour can be induced by inserting a pessary tablet or gel into the vagina, or by swallowing a tablet. Sometimes, medicine is given through a drip into a vein in the arm.  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

Pain relief during labour

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. You can use most types of pain relief in labour. You may be able to give birth in water for pain relief in certain circumstances. 

Gas and oxygen (gas and air, Entonox) 

This is a mixture of oxygen and nitrous oxide gas, which you breathe through a mouthpiece. It won’t remove all the pain, but it can make it more bearable. Some people find it makes them feel sick, or sleepy, while others find it very relaxing. Many people like it because it’s easy to use and you can control the mouthpiece yourself. 

Pethidine or Diamorphine 

Pethidine or Diamorphine is given by injection into your thigh or bum. It doesn’t numb you completely but can reduce the pain. It takes about 20 minutes to work, and lasts between 2 and 4 hours. 

It can make some people feel woozy or sick. Some people find they can’t remember all of the birth – it becomes blurry or fuzzy – and you may feel drowsy afterwards. Anti-sickness medication can be given (by tablet or by an injection) to help reduce this if you’re feeling sick or dizzy. Speak to your midwife if you start to feel this way as there is usually a way to reduce this side effect. 

Epidural 

An epidural is a type of local anaesthetic. It numbs the nerves that carry pain impulses from the birth canal to your brain. It shouldn’t make you feel sick or drowsy. 

If your baby has died sometime before you are in labour, your blood clotting will usually need to be checked before you have an epidural. Therefore, it is a good idea to let someone know you are thinking about this type of pain relief in advance. A very fine tube is inserted into your spine by a specialist doctor (anaesthetist) and remains there throughout the birth. You or your midwife may be able to top up the epidural by pressing a button on a machine.

An epidural usually gives complete pain relief. However, it isn’t effective for everyone. The Obstetric Anaesthetists Association estimates that 1 in 10 women who have an epidural during labour need to use other methods of pain relief. 

You may need a catheter to empty your bladder. You’ll be monitored regularly, and your blood pressure will be 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.

Read more about pain relief during labour.

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 whether you have the injection or not.

It can be difficult at this point because you might just want to be left alone with your baby. But the midwives need to continue caring for you until your placenta is delivered.

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. This is more likely to happen in stillbirths that happen earlier in pregnancy.

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.

Caesarean section 

Doctors usually recommend a natural or induced labour to deliver your baby. This is because a caesarean (or c-section) is major sugery, which carries more risks and can affect future pregnancies. It usually requires a longer recovery period in hospital, and at home, 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 so you can decide what you would prefer.

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 screen is placed across your body so you cannot see what’s being done but the doctor or nurse can talk you through it. A cut about 10 to 20cm is made across your lower tummy and womb. You may feel some tugging or pulling.

The whole operation normally takes about 40 to 50 minutes.

A general anaesthetic puts you to sleep during the c-section, and may be needed in certain circumstances. There may be some discomfort in your tummy for the first few days and you’ll be offered painkillers.

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 them first. Or you may not want to see them at all.

"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. Read Sarah's story.

It’s also fine to change your mind. Taking some time to think about what you want to do 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. Read Shelley's story.

When your baby is born, you can ask your midwife to describe them to you. The midwife could take a photo of your baby before you see them. Or you might decide together to just look and touch your baby’s hand and feet, while the rest of them stays covered.

"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

Your midwife can wrap your baby in a blanket for you, which can help cover up any deterioration, if there is any. They can also place your baby in a Moses basket, or cot, in the room, so that you can choose when to see them.

"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

Spending time with your baby after they're 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 them. You may also be able to take your baby home in a cuddle cot if you wish. 

"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. Read Rachel's story.

Read more about spending time with your baby and creating memories.

More information and support

If you decide to spend time with your baby after they're 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're worried about the practicalities of what happens next, please read our section on the practical issues, such as registering your baby.

Going through this experience can often be very traumatic. A bereavement support officer or bereavement midwife will be able to offer support. Tommy’s is also here to help you. You can talk to a Tommy’s midwife for free, Monday-Friday, 9am-5pm. You can call them on 0800 0147 800 or email [email protected]. All our midwives are trained in bereavement support and will be able to talk to you about what you’re going through.