Preventing stillbirth

It’s not always possible to understand why stillbirth happens. But there are some things you can do to reduce the risk.

If you feel that something is wrong, or if you are worried about the baby, call your midwife or doctor to talk about it. Don't worry if you've talked about it before and don't be concerned about whether you're wasting anyone's time. This is your pregnancy and it's important to trust your own instincts if you feel something isn't right.

Unfortunately, it’s often not possible to know the cause of a stillbirth and it can’t always be prevented. But there are things you can do to reduce your risk. These include: 

  • not smoking 
  • avoiding alcohol, caffeine and drugs 
  • attending all your antenatal appointments 
  • making sure you’re a healthy weight before trying to get pregnant
  • protecting yourself against infections 
  • avoiding certain foods 
  • looking out for any red-flag symptoms such as stomach pain, vaginal bleeding and itching, and seeking help from your midwife immediately
  • monitoring your baby's movements and letting your midwife know straightaway if you’re worried about any reduction
  • going to sleep on your side, not on your back.
  • managing any pre-existing medical conditions (this may mean you have to change or stop your medications). 

We have included more information about some of these below. You might also find it useful to read our information about symptoms and risk factors to learn more about risks, signs to look out for, and conditions that can affect your pregnancy and baby. 

Quit smoking

The chemicals in cigarettes prevent oxygen and nutrients reaching your baby. Thousands of these chemicals also cross the placenta to your baby. If you stop smoking now it will make a big difference to your health and the health of your developing baby. The earlier you give up smoking in pregnancy, the better. But quitting at any stage will benefit both you and your baby. 

There is a lot of support available to help you stop smoking.

Monitor your baby’s movements

You may feel your baby move as early as 16 weeks of pregnancy, but most people usually feel something between 16 and 20 weeks, and almost everyone should feel movements by 24 weeks.  If this is your first pregnancy, you may not notice your baby’s movements until you are more than 20 weeks pregnant. Movements feel different to everyone, but you might feel kicking, swirling, fluttering or rolling. Over time, you will get to know your baby’s unique pattern of movements. 

If a baby is not well, or not receiving enough nutrients and oxygen, they are likely to move less to save energy. Noticing when this happens and contacting your hospital immediately is very important. Studies have shown that around 55% of women who experienced a stillbirth noticed a reduction in baby movements.  It is not true that babies move less towards the end of pregnancy. You should continue to feel your baby move right up to the time you go into labour and during labour. 

Contact your midwife or maternity unit immediately if you think your baby’s movements have slowed down, stopped or changed. There are staff on the hospital maternity unit 24 hours a day, 7 days a week. Do not wait until the next day – seek help even if it is the middle of the night or the weekend. 

Do not use any hand-held monitors, dopplers or phone apps to check your baby’s heartbeat. Even if you do detect a heartbeat, this does not guarantee that your baby is well.

Read more about why we don’t recommend using dopplers

Go to sleep on your side in the third trimester

Research has shown that going to sleep on your side in the third trimester, from 28 weeks of pregnancy, is safer for your baby. This includes night sleep and daytime naps. 

Researchers do not know for certain what causes the increased risk of stillbirth when sleeping on your back, but we do know that the following could play a part:

  • When sleeping/lying on your back, the baby and womb put pressure on the main blood vessels that supply the womb and this can limit blood flow/oxygen to the baby.
  • Further recent studies have shown that when a woman lies on her back in late pregnancy (compared to lying on her side) the baby is less active and has changes in heart-rate patterns. This is thought to be due to lower oxygen levels in the baby when the mother lies on her back.

Read more about sleep position and stillbirth.

Stay a healthy weight during your pregnancy

Obesity (having a BMI over 30) increases the risk of stillbirth. It’s a good idea to get to a healthy weight before getting pregnant. If you’re pregnant and worried about your weight, get advice from your GP about managing your weight, eating well and staying active during your pregnancy.

Avoid alcohol and drugs

It’s important to avoid alcohol and drugs during your pregnancy. They can seriously affect your baby's development and increase the risk of miscarriage and stillbirth. Drinking more than two cups of instant coffee a day (200mg) increases the risk of miscarriage and stillbirth. You may want to switch to decaffeinated drinks or reduce your caffeine intake while you are pregnant.

You can find out your caffeine intake by using our caffeine calculator

Tips for looking after you and your baby during pregnancy

  • Go to all your antenatal appointments and scans so midwives can check your baby’s growth and development. They will also check your blood pressure for signs of conditions such as pre-eclampsia, which has been associated with stillbirth.
  • Give a urine sample at every antenatal appointment.
  • Read about how to avoid infections in pregnancy that can affect your baby. 
  • Tell your midwife about any bleeding, stomach pain or other symptoms that are worrying you.
  • Report any itching to your midwife. Itching can be a sign of a liver disorder called obstetric cholestasis (intrahepatic cholestasis) of pregnancy. This condition has been linked to an increased risk of stillbirth, but with careful management most babies are unaffected.
  • Get your flu vaccination in pregnancy. The vaccine is recommended by the NHS as well as the RCOG and RCM because of the benefits to you and your baby. Getting the flu in pregnancy is serious. As well as increasing your risk of stillbirth, it puts you at risk of complications. 
  • Start taking folic acid before you get pregnant to reduce the chance of spina bifida. This should be continued for the first trimester. Vitamin D supplements are also recommended for the whole duration of your pregnancy. Your midwife or obstetrician can advise on the specific dose you'll need.
  • Avoid certain foods such as raw meat, certain cheeses and unpasteurised dairy products.

How Tommy's research is helping understand why stillbirth happens

Without more research, we will never know why so many babies die before birth. Tommy’s Manchester Research Centre is focused on learning more about the main causes of stillbirth and how it can be prevented.

The Manchester Placenta Clinic is a specialist service for pregnant women at risk of placental problems, which can potentially lead to fetal growth restriction. We believe the majority of stillbirths could be prevented and we want to find out how. 

Our research depends on fundraising and donations. Find out more about how you can support our research. 
 

  • Efkarpidis S, Alexopoulos E, Kean L, Liu D, Fay T. Case-control study of factors associated with intrauterine fetal deaths. MedGenMed 2004;6:53.
  • Heazell AEP, Li M, Budd J, Thompson JMD, Stacey T, Cronin RS, Martin B, Roberts D, Mitchell EA, McCowan LME. Association between maternal sleep practices and late stillbirth – findings from a stillbirth case-control study. BJOG2017. Available at: https://doi.org/10.1111/1471-0528.14967.
  • NHS. Preventing stillbirth. Available at: www.nhs.uk/conditions/stillbirth/prevention/ (Page last reviewed: 16 March 2021, Next review due: 16 March 2024)
  • NHS. Stop Smoking in Pregnancy. Available at: www.nhs.uk/conditions/pregnancy-and-baby/smoking-pregnant/ (Page last reviewed: 7 November 2019 Next review due: 7 November 2022)
  • NHS. The flu jab in pregnancy. Available at: www.nhs.uk/pregnancy/keeping-well/flu-jab/ (Page last reviewed: 10 September 2019 Next review due: 10 September 2022)
  • RCOG. Reduced Fetal Movements. Green top guideline No.57. February 2011.

 
 

Review dates
Reviewed: 11 February 2022 | Next review: 11 February 2025