Conception After Stillbirth
About 50% of women choose to become pregnant again after a stillbirth. It’s common to have a heightened level of anxiety or depression during subsequent pregnancies and postpartum with your new child. Giving birth to another baby isn’t a cure-all for the mental health symptoms from your previous stillbirth. It’s wise to seek emotional support after a pregnancy loss, regardless of whether you decide to embark on another pregnancy or not.
Optimal Timing
Medically, there’s no solid evidence that warrants waiting a specific amount of time before you conceive again. It’s commonly advised to wait about three months after a pregnancy loss to let your body return to normal, but there are no significant physiological benefits associated with waiting. In fact, research shows that couples who try to get pregnant again within three months of pregnancy loss are more likely to conceive than those that wait longer. Unless you have individual medical circumstances that require a longer waiting period, the decision about if or when to conceive again should be based on you and your partner’s mental and emotional readiness to take on another pregnancy. Here are some of the risk factors for stillbirth and ways to care for your mental health.
Stillbirth Risks
In the United States, stillbirth occurs in one out of every 160 deliveries. Stillbirth is typically defined as a fetal death beyond the 20th week of gestation. Some of the risks of stillbirth are preventable and some are not. If the cause of your stillbirth is known, work with your doctor to determine your risk of recurrence. Many people who have experienced a stillbirth are capable of healthy and safe future pregnancies. The risk factors associated with stillbirth include:
Assisted reproduction: In vitro fertilization (IVF) increases the risk of stillbirth by two- to three-fold after adjusting for other variables. Co-morbid conditions: Mothers with diabetes or high blood pressure are at higher risk of stillbirth. Male fetus: Worldwide data indicates a 10% higher risk of stillbirth in male babies versus females. Maternal age: The chances of stillbirth are higher for mothers under age 15 or over age 35 compared to those who fall between this age range. Maternal weight gain: High pre-pregnancy weight, or excessive weight gain during pregnancy, are both associated with a greater risk of stillbirth. Past pregnancy issues: A history of small for gestational age babies, preeclampsia, cesarean section, or past stillbirth increases the risk of future stillbirths. Pregnancy complications: Placental abruption, fetal growth restriction, genetic abnormalities, infection, and late-term births are all associated with higher rates of stillbirth. Pregnant with multiples: There is a 2.5-times higher risk of stillbirth in a twin pregnancy compared to singletons. Race: Non-Hispanic Black women have double the rate of stillbirth compared to other racial groups. Substance abuse: Illicit drug use, smoking, and exposure to secondhand smoke increase the risk of stillbirth. Umbilical cord events: About 10% of stillbirths are associated with abnormalities in the umbilical cord.
Reduce your stillbirth risk by not smoking during pregnancy (and avoiding second-hand smoke), getting regular prenatal care, and following the general recommendations on how to have a healthy pregnancy. If you’re overweight or have diabetes or high blood pressure, work on getting a good handle on your health before conception to improve your pregnancy outcome.
Common Questions
Many people who have experienced stillbirth wonder if there is anything they can do specifically to prevent stillbirth in the future. Your doctor will be your best resource on making sense of and reducing your personal risk. Understanding the cause of the stillbirth can help your doctor to prevent it from happening again, but sometimes the reasons for stillbirth are unclear or unchangeable. Whether or not the cause is known, the best thing to do is to stay in close contact with your doctor and follow their advice on optimal pre-pregnancy and prenatal care. Some risk factors are out of your control, such as race, issues with the placenta, most birth defects, the sex of your baby, if you are carrying multiples, or how early in pregnancy the stillbirth occurred. A stillbirth that happens earlier in pregnancy is more likely to be repeated. On the other hand, many other issues can be mitigated, as noted above, such as treating comorbid conditions and managing gestational weight gain. Getting extra close prenatal care monitoring, which may include more frequent testing and ultrasounds, can also increase your odds of a successful future pregnancy.
Stillbirth and Mental Health
Oftentimes, close friends and family members aren’t emotionally equipped to provide the right kind of support during tragedies like a stillbirth. Grief is a sensitive topic that makes many people uncomfortable. If you’re unable to find comfort in the company of loved ones, seeing a qualified therapist can provide you with tools to wade through the tides of grieving. Mindfulness techniques such as yoga, deep breathing, and meditation can make a positive impact while grieving a stillbirth. Ask your doctor about a mental health referral or group program to address your emotions and help clear the path forward.
A Word From Verywell
It’s OK to have mixed feelings about the idea of another pregnancy after a stillbirth. You should never feel rushed or pressured to conceive again soon if you aren’t ready. What is right for one couple might not be right for another. Always remember that help is available to support you on whichever path you choose to take.
