Preventing stillbirth

Information about some of the ways you can reduce the risk of stillbirth in pregnancy.

Often we don't know the cause of every stillbirth and it can’t always be prevented. But there are things you can do to reduce the risk of stillbirth.

Four top things you can do to reduce your risk of stillbirth

  1. If you smoke, this is the most important change you can make. Smoking puts you at higher risk of stillbirth and can harm your baby in other ways too. If you smoke, get support to quit while you are pregnant. Quitting smoking in the first trimester of pregnancy however reduces the risk of stillbirth to that of a non-smoker.
  2. In the third trimester you should go to sleep on your side as research has shown that this will help to prevent stillbirth.
  3. You can also monitor your baby’s pattern of movements, which will make it more likely that you’ll notice if they become unwell.
  4. Go to all your antenatal appointments and scans. These are designed to spot problems early so that anything that is spotted can be treated early before.

Monitoring your baby’s movements

Your baby’s movements are a sign that they are well. When they are unwell, the first thing they do is move less to conserve their energy. Slowing down of movement is noticed by the mother in around half of stillbirths. Being aware of their pattern of movement allows you to be aware and act if movements change in any way. Going to the hospital in time is important to make a difference.

Never use a hand-held Doppler to listen to your babies heart beat at home. it is important your baby is checked by trained professionals who will carry out the necessary checks to ensure your baby is safe.

From between 16 to 24 weeks you’ll start to feel your baby moving. Most babies settle into a pattern by 24 weeks. They continue to move more right up to the labour and birth. Your babies movements DO NOT slow down as your due date approaches.

There is no set pattern of normal movements. They’re unique to your baby. Over time you’ll get to know your baby’s own pattern of movements.

Contact your midwife immediately if you notice your baby’s movements slow – don’t put it off until tomorrow. And don’t wait until after the weekend. You can access the labour ward of a hospital any time, including over the weekend or in the evening.

There are some key things to remember about a baby’s movements:

  • Babies DO NOT move less towards the end of pregnancy.
  • You’ll feel your baby move right up until you go into labour, and throughout your labour too.
  • 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 baby’s movements in pregnancy.

Going to sleep on your side in the third trimester

 Research has shown that going to sleep on your side in the third trimester is safer for baby. This includes night sleep and day time naps. 

Sleep position in the third trimester is important because if you are on your back the combined weight of baby and womb puts pressure on other organs in your body.

Researchers do not know for certain what exactly is causing the increased risk of stillbirth, but we already know the following, which could play a part :

  • When sleeping/lying on your back the baby and womb put pressure on the main blood vessels that supply the uterus and this can restrict 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 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 risk here.

Quitting smoking

The chemicals in cigarettes prevent oxygen and nutrients reaching your baby. These thousands of chemicals also cross the placenta to your baby. There is lots of support out there to help you stop smoking

Staying a healthy weight during your pregnancy

Obesity during pregnancy (when your BMI is over 30) can cause complications. It’s best 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 by eating well and staying active during your pregnancy.

Avoid alcohol and drugs

Drinking heavily and taking drugs in pregnancy can seriously affect your baby's development and in-crease the risk of miscarriage and stillbirth.

Look after yourself

  • Go to all your antenatal appointments and scans so midwives can check your baby’s growth and development. They’ll also test for signs of conditions that can affect mums, such as pre-eclampsia, which have been associated with stillbirth. Give a urine sample at EVERY antenatal appointment.
  • Read up on how to avoid infections in pregnancy that can affect your baby. 
  • Tell your midwife about any bleeding, stomach pains 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/intraheptic 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 RCOG and RCM because of the benefits to you and your baby. Getting the flu in pregnancy is a serious matter. As well as increasing your risk of stillbirth it puts you at risk of complications.
  • Start taking folic acid before conception to reduce the chance of spina bifida. This should be continued for the first trimester. Vitamin D supplements are recommended for the whole duration of your pregnancy. Your midwife or obstetrician can advise on the specific dose based on your individual needs.
  • Villamore E and Cnattingius S. (2006) Interpregnancy weight change and risk of adverse pregnancy outcomes: a popu-lation-based study The Lancet, 2006, 1164. 368(9542):1164-70.
  • Lawn JE, Blencowe H, Waiswa P, et al (2016) Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet 2016;S0140–6736(15)00837-5. DOI: 10.1016/S0140-6736(15)00837–5.
  • MBRACE-UK (2017) Perinatal Mortality Surveillance Report.
  • RCOG (2011) Green Top Guideline No 57 Reduced fetal movements. Royal College of Obstetricians and Gynaecologists.
  • Flenady V, Wojcieszek AM, Middleton P (2016) Stillbirths: recall to action in high-income countries. Ending preventable stillbirths 4. Lancet 2016;387(10019):691–702.
  • NHS Choices. Stillbirth (accessed 19 February 2016) Next review due: 01/02/2018 Available at: 
  • RCOG (2011) Why your weight matters during pregnancy and after birth, Information for you, Royal College of Obstetricians and Gynaecologists, London, England
Review dates
Last reviewed: 31 August 2017
Next review: 31 August 2020