Loss after 20 weeks in pregnancy is medically referred to as stillbirth.

Luckily, the risk of this type of loss is rare.  The current rate in the US at 6/1000.  Still, it’s a common fear among pregnant women.

Here are the most common conditions associated with stillbirth, and what you and your doctor can do to help lower your risk of a bad out come.

High Blood Pressure and Pre-eclampsia

When I was pregnant, my husband came to only a couple of my prenantal visits.  Afterward, he remarked, that they seemed pretty pointless. “All they did was weigh you, check your blood pressure, make you pee and listen to the heart beat.” He said. “It only took 5 minutes.”

I explained to him how much valuable information these routine checks actually gives the doctor.  The earliest signs of preeclampsia can show up in these numbers. By intervening  early in preeclampsia, we can help improve the safety of delivery and prevent bad outcomes.

Hypertension effects all the blood vessels in the body, including the placenta. Over time it can reduce nutrient flow to the baby.

Preeclampsia is a specific type of hypertension that you get only during pregnancy.  It is more common in the final weeks of pregnancy which is one of the main reasons we make you come to the doctor more frequently during the last month.

Attending your regular prenatal visits is the best screening for preeclampsia.  If you do have hypertension, then your doctor will often do ultrasounds and nonstress tests to make sure that your baby is doing well.

Diabetes

Much as high blood pressure effects the entire body, so does diabetes.  If you have diabetes, it is best to meet with your doctor before conception to optimize your health and review your specific risk. Well controlled blood sugars, frequent ultrasounds and nonstress tests are usually implemented to help reduce your risk of complications.

Gestational diabetes that is controlled only by diet, does not increase your risk of still birth.  If insulin is required, then gestational diabetics will also need nonstress tests.

Smoking

Smoking is bad. Don’t do it.  It is a completely preventable cause of stillbirth.

If you are having difficulty quitting smoking during your pregnancy, then talk to your doctor about medications or counseling that may help you stop.

Cord Accident

As I deliver a baby, 25% percent of the time the cord is wrapped around the neck. Usually it is only loosely draped and I can easily move it out of the way. Sometimes it is tight and I have to clamp it and perform maneuvers to safely deliver the wee one. When I inform the parents, they often look horrified.  I reassure them that this is common. The cord is made of a very pliant rubbery tissue that is designed to withstand the pressures of the womb.

One mom recently said that she had been terrified her last few weeks of pregnancy worrying that her baby might get entangled in its cord and die. This had happened to someone she knew. I realize this an extremely common fear.

A stillbirth due to cord accident is very rare, and is usually not due to the cord around the neck. There is not a way on ultrasound to determine if the baby is at risk for cord accident.

The best precaution is to perform daily movement counts after 28 weeks.  There are several ways to do this. Each day you want to make sure that the baby has an active time. We recommend our patients to feel for at least 6 distinct movements in an hour. This doesn’t need to be EVERY hour, just pick one hour during the day when baby is normally active. If you don’t get 6 movements, then lay on your side and drink  juice.  If he still doesn’t move, then call your provider.

Post Dates

The risk of stillbirth begins to increase if a baby goes more than 7 days past its due date. The risk increases exponentially (200 fold ) if the baby goes more than 2 weeks over the due date. For this reason, we usually recommend induction at 7-10 days overdue.

Other

Genetic conditions such as down syndrome and trisomy 18 are another common cause of stillbirth.

A BMI of >40 is associated with an increased risk of stillbirth.  Repeat ultrasounds and nonstress tests are also recommended for morbidly obese women.

And still, a small percentage of stillbirths occur for unknown reasons.

Stillbirth is one of the biggest fears of pregnant women. However, it is very rare. Even if you have one the conditions mentioned, your risk is less than 1%. Most of you are already doing everything you can to help prevent it: attending your regular prenatal visits, not smoking and doing your daily fetal movement counts. If you still struggle with fear, talk to your provider about your specific concerns and see Jessica’s article on Fighting Fear in Pregnancy.

I hope these facts help calm your anxiety but please, let us know how we can be praying for you. Do you find yourself fighting this type of fear in your pregnancy?

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As I was praying this week, I was reminded of the many women in our community who are currently pregnant after enduring a loss of some sort. Several after experiencing miscarriage. . .some after years of waiting for their positive pregnancy test. A few of you have shared with me personally that you are battling fear as you walk through your pregnancy. Oh how I understand that war. Wanting so badly to rejoice in your longing fulfilled but being paralyzed by the wait and the unknown.

Friends, I understand your fears and so does your heavenly father. He intimately knows every moment you have experienced and every one that is to come. The hardest part about faith is believing God is good when we’ve experienced something oh so bad. But the truth remains. . .he is faithful.

The best way I knew to fight my pregnancy fears was with the Word. I had several scriptures that I clung to as I waited to have my babies (both of them) placed safely in my arms. I also wrote a prayer of declaration that I prayed every.single.day when I was pregnant with Hope. We shared it in the book and I will share it with you here. I encourage you to write your own prayer of declaration over the child in your womb. Or you are welcome to use mine.

I asked the Lord to show me 10 scriptures to share that will help you fight fear throughout your pregnancy. I pray you will come to understand these powerful words in a more intimate way as you speak them over your journey. Trust him. His is good and he is worthy of your complete trust. . .no matter what you’ve gone through in the past.

It’s a new day. A new season. Life is growing inside you.

My Prayer of Declaration

Dear Lord,

I declare that you are the author and giver of life. Your Word says that all things have been created by and for you. You are before all things, and in you all things hold together. Today I ask that the spirit of life me on me and in me, providing everything this baby and my body need to bring forth life to the glory of God. I stand on the goodness and faithfulness of you, Lord, that will bless us with this healthy and whole child. May my life and theirs bring glory and honor to you. In Jesus’ name, Amen.

To download a PDF Printable of 10 Scriptures for Fighting Fear in Pregnancy, click here.

Are you pregnant? I’d love to do an expectant mom roll call. Let us know if you are expecting so we can be praying for you. Or if you have a friend or family member that needs prayer, please let us know.

This morning I got a call from Dr. Rupe. She said that she received the final report from my 20 week ultrasound and a specialist noticed a soft marker (aka “an unusual ultrasound finding”). Baby boy had a bright spot on his bowel. She didn’t seem overly concerned about this finding as 99% of the time it means nothing. But it is one of the soft markers that detects downs syndrome so I went in to have my blood drawn for a quad screen just to make sure. They will repeat my ultrasound in a month and check it again.

Honestly, after having written this book with Dr. Rupe, I was not too concerned about this finding. I realize that many soft markers end up being nothing. But I’d by lying if I didn’t admit that scary thoughts have crossed my mind in the past few hours. I finally had the chance to sit down with our book and re-read chapter 5 where Dr. Rupe discusses “soft markers”. I love the way she approaches the subject of abnormal ultrasound findings. Dr. Rupe shares the facts but her words are always balanced with statistics and faith. Because our desire is to help women have a peace-filled pregnancy, she chooses her words carefully to dispel fear. Since it seems the good Lord wants me to experience almost every aspect of pregnancy that we discuss in the book, I am not surprised to be facing this issue.

In chapter 5 of the book I talk about practical ways to fight fear, anxiety and worry. I suppose one never thinks about how hard it is to take their own advice until they have to. But I am purposing to do just that as I wait.

Whether it’s an abnormal ultrasound finding or blood test, waiting to get beyond the miscarriage zone or any trial in our life that brings anxiety and worry, we must be ready to fight our fears. Here are the simple, practical ways we suggest doing so:

1. Memorize scripture. My favorite for anxiety in pregnancy: For by him all things were created: things in heaven and on earth, visible and invisible. . .all things were created by him and for him. He is before all things, and in him all things hold together. Colossians 1:16-17

2. Stop whatever you are doing and breathe, then pray. Simply clearing our mind and focusing it on the Lord will bring great peace.

3. Write a prayer of declaration. This one has been very helpful to me. Ask the Lord to give you strong and faith-filled words. Write them down and then declare them out loud when you begin to worry.

4. Talk with someone about your concerns. Our support system is so important. Lean into your spouse and loved ones. They are walking this out with you.

I appreciate your prayers. And as always, we’d love to know how we can be praying for you along your pregnancy, trying to conceive or motherhood journey.

Love,

Jessica