Stillbirth and Infant Loss: Care, Choices and Grief

What these words mean

• A stillbirth is when a baby dies in the womb at 20 weeks of pregnancy or later. In the U.S. about 1 in 175 births ends this way. Loss before 20 weeks is called a miscarriage.
• Infant loss includes a baby who dies after birth, in the NICU, or later in the first year, including sudden unexpected infant death.
• Often no clear cause is found. It is almost never because of something a parent did or didn't do.

Time with your baby

• Many families find it helps to see, hold, name and spend time with their baby, but it's your choice, and you can change your mind.
• You can ask for photographs, handprints and footprints, a lock of hair, the hospital bracelet and a memory box. Some volunteer photographers specialize in this.
• Siblings, grandparents and others can meet the baby if you wish. Faith or cultural rituals, such as a blessing or washing, can usually be arranged.

Tests and paperwork

• You'll be offered tests to look for a cause: an autopsy, an exam of the placenta, genetic testing and blood tests. Even partial answers can help with planning a future pregnancy.
• Ask the hospital's social worker or bereavement team about certificates, funeral or cremation options, and costs. Many states offer a certificate of birth for a stillborn baby.

Your body afterwards

• You'll need postpartum care like anyone who has given birth: bleeding, stitches or a C-section wound all need time (see the postpartum recovery guide).
• Milk often comes in after the birth, which can be very painful emotionally. Options include a snug, supportive bra, cold packs, and expressing just enough for comfort while supply fades. Some parents choose to pump and donate milk to a milk bank. Ask your provider about other options.

Grief

• Grief comes in waves: shock, numbness, anger, guilt, longing. It doesn't follow a timetable.
• Partners often grieve differently, one wanting to talk and one wanting to keep busy. Neither is wrong. Be patient with each other.
• Talk to older children simply and honestly ("the baby died; their body stopped working"), and avoid saying the baby is sleeping, which can scare them.
• Friends and family: say the baby's name and remember the due date and anniversaries.

Support

• Hospital bereavement teams, local loss groups and Postpartum Support International's loss support groups connect you with parents who understand.
• Grief counselors who specialize in pregnancy and infant loss can help.

A future pregnancy

Many families do go on to have another baby. It's often an anxious time; ask for extra visits and reassurance scans, and plan support early.

When to check in

• See your provider for your postpartum checkup even if it feels hard; you can ask for a quiet waiting area.
• Get support if you can't eat, sleep or function for weeks, or grief turns into hopelessness. The National Maternal Mental Health Hotline is 1-833-852-6262.
• If you're thinking of ending your life, call or text 988, or call 911.