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Stillbirth is more properly defined as the death of a fetus before 20 weeks gestation ~~Bob

No, Bob. Stillbirth is AFTER 20 gestational weeks. Miscarriage is the term for prior to 20 gestational weeks. Please check your facts.

Joanne Cacciatore, LMSW, FT CEO, MISS Foundation http://www.missfoundation.org

— Preceding unsigned comment added by 149.169.184.244 (talk • contribs) 21:40, 11 July 2006

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Anon user at 12.64.66.67 wrote in article (moved to talk by Infrogmation 06:08 May 15, 2003 (UTC)):

Photograph of Breanna Lynn Bartlett-Stewart, Stillborn, September 6, 2000.

I think we should have a link to a picture of a stillborn baby for research purposes...

Perhaps more about bereavement therapy as well???

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I'm surprised we can link to off-site jpg's, I thought that was no longer done. For 12.64.66.67, we generally put comments about articles on the talk page, and the content on the article page. So if you are able to write something about bereavement counseling following pregnancy loss, you could place the information in the article. My impression, for what it is worth, is that photographs of the dead tend to disturb people -except perhaps very special audiences --rather than educate them. -- Someone else 06:25 May 15, 2003 (UTC)

--Photographs of stillborns abound across the Web, and many find them hauntingly beautiful. I think Bree Lynn here fits the latter.

Stillbirth is the delivery of an infant which is dead at birth, regardless of the stage of development.

It's only a stillbirth after 20 weeks. Before 20 weeks, its a miscarriage. ~~Bob

You win more flies by not deleting opinions. Isn't this thing about debate vs ignorance???

--Bob

In fact, I just stumbled on http://www.missingangel.org/ ... It's freakish. ☢ Ҡieff⌇↯ 05:38, 7 January 2006 (UTC)

General

I felt the need to give this article a major overhaul for several reasons:

1. The introduction was repetitive, confusing, and some of it was factually incorrect
2. There was a lot of "topic wandering" and the content was not well organized
3. Most of the article appeared to be copied directly from support materials provided by another source
4. The extensive grief data should be summarized here, and expanded in a more appropriate article, as it is essentially a different (though related) topic
5. Most of the material is very heavy POV
6. wikipedia is an encyclopedia, not a grief counselling site...this material in it's current tone is more suited to a wikibook discussing the effects of stillbirth and/or perinatal death, and coping strategies

I've pasted here the material that I felt was not suitable for this article so it can be easily transferred to the appropriate areas

==Perinatal Bereavement: Loss at the time of Pregnancy==
Perinatal death in the U.S. alone can affect as many as 40,000 families.  While the causes may be many, the experience of loss is
nearly universal.  "Perinatal bereavement" is the grief experienced in and around the time of birth, and the initial synthesis
of the grieving process may last two years or more.  Perinatal death includes miscarriages, stillbirths and neonatal deaths.
Sudden Infant Death Syndrome is usually considered to be a separate category.  Loss at abortion may also be considered in this
general area.
At the death of an infant, parental expectations turn upside down. At a time when plans are made to announce a birth, announcements
of the death take place, usually from a hospital.  Reactions to the death early on may include shock and numbness. The reality of
the event is often difficult to assimilate, and may be followed by waves of grief and despondency.   Over the first few weeks,
these opposite waves of feelings of loss, numbness, ebb, and flow, are often followed by depression, and occasionally, rage over
people or events associated with the timing of the infant's death.  Characteristics of all normal grief including perinatal
bereavement include appetite and sleep disorders, stress related symptoms and illnesses, a lowering of the immune system's
function, depression, nightmares, and even having random experiences of the pregnancy in what is termed 'phantom' movement or even
cries.
== Morbid or Difficult Reactions ==
Morbid or complicated reactions include the inability to do such activities as taking down a nursery even after a year or more,
extreme phantom experiences which cause distress, 'replacement child syndrome' in which the next child is saddled with the
expectations of the 'ideal' first child, or 'vulnerable child syndrome' in which all subsequent children are seen as very fragile
and prone to harm or illness.
== Essential Choices & Facilitation of Grief ==
While grief cannot be treated or 'cured' as an illness, there are things which aid families experiencing perinatal loss.  These
include: 1) Choices in making funeral plans, 2) Choices in early hospital arrangements 3) Seeing, holding and saying goodbye to the
infant, which is thought to alleviate experiences of phantom crying and bring closure to the death, 4) Crisis intervention and
effective listening by health care providers and loved ones, 5) Keeping memorabilia to anchor grief such as clothing, hospital
bracelets or footprints/ultrasound photos, and 6)  Freedom to allow for individual differences in relinquishment of the infant in
the grieving process.  There is often a blurr between what is normal and not in perinatal bereavement.
== Negative Consequences ==
When the intense grief of perinatal loss is not dealt with, severe familial reactions may occur including loss of intimacy, sexual
dysfunction, divorce, alcoholism, juvenile delinquency and other difficulties.  Openness and acceptance of the normal process of
grief along with careful listening skills may often bring about the greatest effect.
== Intervention ==
Over the past 25 years, radical changes have been made in in-hospital effectiveness in treatment or intervention with perinatal
bereavement.   International Self-Help Resources include SHARE - for the support of parents experiencing Stillbirth, HAND - for
those experiencing a neonatal death, and The MISS Foundation - a volunteer-based organization committed to providing crisis support
and long term aid to families after the death of a child from any cause.
== External links ==
*The Forgotten Grief: Perinatal Death
*The MISS Foundation
*SANDS The Stillbirth and Neonatal Death Society (UK)

I WOULD like to keep some statistical information in the article - the rate of occurance - but it should not be limited to the US rate. bcatt 09:39, 7 February 2006 (UTC)

Question - should we distinguish between "stillbirth" as essentially "the birth of a dead baby" and "a stillbirth" as essentially "a dead newborn"? It seems to me that we're using the word "stillbirth" as both an event and a "thing", which could be confusing. I vote for calling the baby itself a "stillborn" or a "stillborn baby" and reserving "stillbirth" for the event itself. Ideas here?

I do agree that the event is called stillbirth, while when referring to the baby itself, stillborn would be used, whether it is in a verb or noun sense. For example:

• It was a stillbirth (verb)

  The baby was stillborn (verb)

  The baby is a stillborn (noun)

So, yes, I agree. However, the only part where the infant itself is referred to directly is the photo caption, where she is appropriately referred to as a stillborn...or did I miss something? bcatt 08:23, 18 February 2006 (UTC)

Just curious - but would anyone object to replacing the word 'fetus' with 'unborn child' in the first sentence passage: "A stillbirth occurs when an unborn child, of mid-second trimester to full term gestational age, which has died in the womb or during labour or delivery, exits the maternal body."? I think it's generally understood that this article is dealing with the stillbirth of a human being. Not often will you hear a person asking a pregnant mother how her 'fetus' is doing. I think 'unborn child' is a more respectful term. Any thoughts? J.Nevels 21:45, 15 June 2006 (UTC)

Drugs

why cannabis alone is excluded from "recreational drugs", and on what grounds, i am unsure. this seems to be the result of marijuana advocates, and may therefore violate NPOV. i think that a citation is needed in this case. Whateley23 19:11, 1 April 2006 (UTC)

Cannabis was not excluded from the category of recreational drugs (as many people do use it for this purpose), but rather was excluded as a substance, which may be used as a recreational drug in some cases, which does not cause stillbirth. The grounds for exclusion is that there have been no conclusive studies that can show that cannabis actually causes stillbirth. The reason why it is the only one excluded is that I am not aware of any other substances used as recreational drugs which haven't been conclusively shown to increase the risk of stillbirth...please correct me if I am wrong about this.

a quick google search shows that marijuana use can increase stillbirth risk. I see no reason to leave this uncited, inaccurate claim in the article (from revision history)...

I did an extensive google search before including that note and was unable to find anything that was either based on scientific studies, or did not lump cannabis in with "hard drugs" (as in "cannabis increases the risk of stillbirth when used with cocaine/cigarettes/alcohol/etc..."). In other words, in order to find something accurate, you have to sift through all the anti-cannabis propaganda to find the non-biased studies conducted for the purpose of finding out the truth, rather than to serve an agenda. And the truth is, hard as some people have tried to find and/or create a link between cannabis use and stillbirth, they still haven't been able to do so, except by referring to subjects who also use other substances that are proven to increase risk of stillbirth. Granted, some studies indicate that cannabis use may have other effects on the fetus during pregnancy, but stillbirth isn't one of them. I was away for a few months, otherwise I would have found a citation earlier, but I am back now and this is what I found:

"There is firm evidence that cannabis use during pregnancy is not associated with higher rates of foetal mortality." (Fried, P.A. (2002). The consequences of marijuana use during pregnancy: a review of the human literature.)

which was included in page 18 of this document.I'm going to put the note back in, but I haven't figured out how to work the footnotes, so if someone can put in a footnote with the above citation, that would be great...my thanks in advance. bcatt 00:43, 13 June 2006 (UTC)

Legal definition

In the UK (I'm not sure about the US) stillbirth has a particular legal definition and requires the birth to be registered. I remembered this vaguely from being pregnant but the research I have just done show there was a UK Stillbirth Definition act in 1992 to define stillbirth as the delivery of a dead at birth infant of over 24 weeks gestation. Before this it is classed as a miscarriage and does not require registration . Does anyone object if I start a "Legal definitions" section as I think it's an important distinction. Does anyone know the US definition or what it is elsewhere in the world? Sophia 11:39, 4 May 2006 (UTC)

That sounds like a good idea. I do not know the information about the states. I do not believe there is anything national, but some states may have their own definitions and registration requirements. --Andrew c 00:25, 5 May 2006 (UTC)

Here's a first go:

Legal definition of stillbirth

In the U.K. stillbirths must be registered by law. The Stillbirth Definition Act (1992) requires that any ‘child’ expelled or issued forth from its mother after the 24th week of pregnancy that did not breathe or show any other signs of life be registered as a stillbirth. This must be done within 42 days and a Stillbirth Certificate is issued to the parent(s).

Please tweak as required as I'm not feeling very inspired at the moment. I use the word "parent" as this is the terminology in the uk gov website on filling out the certificate. Sophia 17:59, 5 May 2006 (UTC)

No one has objected so I'll add it to the article and hopefully others can add other countries legal definitions. Sophia 17:33, 7 May 2006 (UTC)

Legal Definition of stillbirth in the US

I've added a bit based on some research I've done here in the United States. Hope it's found to be helpful. J.Nevels 19:45, 9 June 2006 (UTC)

Thank you for helping to fill out this section. It's very interesting to find out how different countries define this very sad event. Sophia 14:03, 10 June 2006 (UTC)

Thanks for the 'thanks'. There is a movement by parents of stillborn children in the United States (through individual actions and through various partental support organizations) to get each state to issue 'Certificates of Birth Resulting in Stillbirth' when a parent's child is stillborn. I volunteer for one of those organizations. My son was stillborn on August 1, 2002. His name was Bump. It's handy to know how an individual state defines fetal death, because that's the definition that state uses for 'stillbirth' - and the states are required to issue a 'Certificate of Fetal Death' (or like wording) for each stillbirth. We recently passed legislation in Texas - and Bump's Certificate of Birth Resulting in Stillbirth was the first to be issued in the State of Texas.J.Nevels 21:02, 15 June 2006 (UTC)

New edits

Under "Prenatal diagnosis":

• most of the second paragraph repeated the information given in the first paragraph, so I integrated the new information into the first paragraph and deleted the repeated info. (note: the nonstress test article needs a lot of work)

Under "Prenatal maternal treatment":

• "The reason for is that it has shown that a woman is better able to prepare emotionally and mentally if she is able to take an active role in her child birth."

  This may be an added benefit, but my understanding is that the reasons center around lower rates of pregnancy-related maternal death with vaginal delivery, and cesarean section increases the risk of future stillbirth (also, vaginal birth triggers the release of hormones that cause the uterus to return to it's normal size and other such physical factors). Additionally, what shows this is not stated...has there been a study on it? If so, it would be good to mention. Otherwise, this is material better suited to a wikibook than a wikipedia article (actually, it's useful info for a wikibook anyway, even if it does stay in this article, so I'll add it to the list below).

• "Younger stillborn children are at further risk of damage to their bodies at birth than full term babies and induction is very rarely used because medications increase the wombs contractions."

  I can't find anything that agrees with this statement. The information I've been able to find states that damage to the body (maceration) increases the longer the fetus remains inside the uterus after death. Further, all the medical sites I have referenced recommend vaginal delivery because cesarean poses a risk to the mother, and because the fetus itself does not have any health or safety risks. My references also state that induction is commonly used in any case where labour does not occur spontaneously, and cesarean is used only if induction fails or there are other complications. Obviously, a person may choose a c-section instead of vaginal birth, but it's not encyclopedic to present a personal choice as a medical recommendation when it is actually the opposite of what is medically recommended

• "It is also note worthy to mention that unless the child is full term the mother rarely goes into labour spontaneously and the child is most often delivered by C-section."

  Again, all the sources I've found say that labour usually begins spontaneously within two weeks (seemingly regardless of gestational age...this part could use some research though), and that induction is recommended before c-section if it doesn't.

• "Many women learn their child has died when arriving at the hospital to deliver and a great portion of those women find that their labour simply stops upon hearing the news."

  I can't find anything supporting this claim (though it seems very likely to be true). However, if it can be cited, it may be an interesting phenomenon to note in the article.

• The third paragraph under this heading addressed things that were covered under the next heading ("Impact on family"), though there were a few new details that I integrated into what was already there. The rest seems more suitable to a wikibook, so I've added it to the list below.

Stuff that is more suited to a wikibook about stillbirth:

*Most often parents learn their baby has passed away when a lack of heart beat is noticed, this is confirmed by the use of
 ultrasound.
*The reason for this is that it has shown that a woman is better able to prepare emotionally and mentally if she is able to take an
 active role in her child birth.
*It has been said that, in the past, women were not allowed to see their child; more recently things are vastly different. The
 parents are offered all the time they need to spend with their dead child. Many bathe and dress their children, taking photos and
 such as it helps to build memories of their child. Most hospitals provide what is known as a Memory Box, blankets and bears
 donated to the hospital mostly by orginizations that are related to child loss and still birth. The blanket is wrapped around the
 child when born and the parents can then take it home when they leave the hospital, often claiming they can 'smell' their baby on
 it for some weeks. The Memory Box is designed to provide a safe and special place the parents can store any mementos from their
 child and the bear is so that the parents don't leave the hospital empty handed.
*The sad fact is that parents come home feeling very confused and alone. Many say they do not fully understand the impact of what
 happened until several months after their child's death. There is a sense of isolation for parents given that most have never met
 or known anyone who lost a child & those who have not can never understand. Support from family & friends is important but rarely
 given when it is truly needed, well after the death. Commonly parents or other family of the bereaved parents step in to take over
 funeral arrangements which in their belief is helping the parents. This is far from what the parents need or want. One of the most
 common complaints mothers have is that they felt out of control, that everyone took over and that her child was long gone before
 they had a chance to fully say goodbye and it is a regret that few get over. Recent studies have shown that this sort of loss
 often leads to post traumatic stress disorder. And the grief they feel has been reported to be far greater than that of parents
 whos children have died of a chronic illness because the suddeness allows no time to prepare.

bcatt 23:46, 13 June 2006 (UTC)

Under "Impact on family":

• I have removed the third paragraph and placed it in the list above, as much of the content is probably useful for writing that wikibook I keep mentioning. The reasons I removed it is that it reads like a commentary on an individual experience of stillbirth, while indicating that this is "the experience" that people have, while the previous paragraphs indicate that the experience varies from person to person, and describes the range of forms this grief may take; it also reads more like a support guide for families than an encyclopedia article; there is some applicable information here, but most of it had already been covered in other parts of the article, and the parts that hadn't, I integrated into the applicable parts of the article.
• The items listed under "Common Reactions After Stillbirth" are also covered in the previous paragraphs, so I have removed this list. I moved the two statistical statements to a new sub heading, though I'm not sure if they belong in the article...if they do though, then there a few others that should probably be added to the list as well.
• I have also removed the lengthly list of "symptoms of grief", as this information belongs in the grief article, which is linked to in the preceeding paragraphs. I have reproduced the items in the list below so it is easy to add any of the items from here if they are missing from the grief article.

  Sypmtoms of Grief: Physical - hyper or hypoactivity, lack of reality, chest and abdominal pain, headaches and nausea, weight loss, change in appetite, tiredness, trouble sleeping, sighing and/or crying, shortness of breath, feelings of loneliness and/or isolation, tight throat; Emotional - confused and numb, sadness, fear, anger, depression, guilt, anxiety, feeling meaningless, longing and loneliness, feeling vulnerable or abandoned; Social - often oversensitive, withdrawn and avoiding others, dependancy; Behavioral - forgetfulness, mental confusion and the inability to think clearly

bcatt 00:26, 14 June 2006 (UTC)

2 Reversions in a Row?

Yes, I am aware that I did two rv vandalism edits back to back. Both were done manually and I missed part of the vandalism with the first edit. --Targetter 16:37, 16 October 2006 (UTC)

Definition

I recently updated the definition of "stillbirth" at the top of the page. However, this edit was reverted for the following stated reason:

First of all, there is nothing "politicized" about the edits I made, and I deplore the accusation. I agree that definitions should prefereably be consistent throughout articles, and therefore I would also edit the definition of "stillbirth" in the miscarriage article.

The definition at the top of this page currently says the following:

Three references are provided: Thompson, Sharon Roseanne. (2005). Definition of stillbirth. Retrieved January 10, 2007. stillbirth. (n.d.) Medterms.com. Retrieved January 10, 2007. stillbirth. (n.d.). The American Heritage New Dictionary of Cultural Literacy, Third Edition. Retrieved January 10, 2007, from Dictionary.com website.

My experience has been that the term "stillbirth" is synonymous with any fetal death, not just those occurring after the mid-second trimester. Therefore, I researched the matter, and edited the definition to read as follows:

I provided three additional references: The American Heritage Stedman's Medical Dictionary, 2nd Edition (2004) ("1. The birth of a dead child or fetus 2. A child or fetus dead at birth"). Retrieved January 10, 2007. Random House Unabridged Dictionary, Second Edition Newly Revised and Updated (1993) (1. The birth of a dead child or organism; 2. A fetus dead at birth.) Med Student Practice Exams, University of Illinois College of Medicine. Retrieved January 10, 2007.

Please note that I preserved references , , and that were previously in the article, and I added three new references , , and to support the edits I made. But then my edits, and my three additional references were summarily deleted, with the accusation that they are somehow politicized. This is absurd. Which of the three references I provided is "politicized"? Stedman's Medical Dictionary? Random House? The University of Illinois College of Medicine?Ferrylodge 22:49, 10 January 2007 (UTC)

A source must state, categorically, that the medical definition of "stillbirth" includes miscarriages before 20 weeks for it to be used to support that claim in this article — otherwise adding the claim is original research. Your sources refer only to a "dead child" or a "fetus dead at birth," which are completely ambiguous as to the stage of pregnancy, and thus cannot be used to infer that stillbirth is medically defined to include miscarriages before 20 weeks. Stillbirth is defined at Miscarriage as "A fetus that dies while in the uterus after about the 20th week of pregnancy." However, the article clarifies that premature births and stillbirths are not generally not considered to be miscarriages, so "stillbirth" is not "synonymous with any fetal death." -Severa (!!!) 23:24, 10 January 2007 (UTC)

I can't imagine a woman who experienced fetal demise and chose to end the pregnancy with a D&C referring to her experience as a stillbirth. To me, stillbirth implies "childbirth", and a fetus still undeveloped enough to have its remains extracted by aspiration doesn't qualify. The cutoff gestation is certainly fuzzy - the miscarriage article says "about" 20 weeks, and specifies that "usage of the terms... may overlap". The stillbirth definition currently in this article is also deliberately vague - it does not specify a week of pregnancy.

But fuzzy definitions are one thing (that I agree with). Implying that the natural demise of a nine-week LMP pregnancy (seven weeks from conception - when the embryo becomes a fetus) is a stillbirth is quite another (that I do not agree with). Lyrl _C 00:28, 11 January 2007 (UTC)

I have made a request for expert comment at Misplaced Pages talk:WikiProject Medicine. -Severa (!!!) 01:01, 11 January 2007 (UTC)

Regarding the medical AND non-medical definitions that I found stating that stillbirth is synonymous with fetal death, it’s exceedingly well-known that there are fetuses younger than five months. No definition of the word “fetus” in any dictionary anywhere says that the fetal stage begins at five months or later. Therefore, the definitions that I found do support the notion that a “stillbirth” can occur before five months.

Lyrl, my goal here is not to find a definition that I like or dislike. The purpose is to write a definition that accurately reflects what the word means, whether I like it or not.

The definition that Severa has been asserting directly conflicts with the most widely accepted legal definition of stillbirth, which is fetal death "prior to the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy and which is not an induced termination of pregnancy." Ferrylodge 01:04, 11 January 2007 (UTC)

Please see WP:NOR. Basically, if a source does not explicity state that a stillbirth can occur before five months, you cannot infer that it does, because that is original research. This is a medical topic, thus the definition in the introduction should be one used generally in the medical community. Also, to suggest the U.S. legal definition is a "common legal and lay definition" is incorrect and undue weight, given that in the "Legal definitions of stillbirth," the U.K.'s definition is said to begin at 24 weeks and Australia's at 20. I don't think that the U.S.'s definition can be taken as indicative of the world at large (WP:BIAS). -Severa (!!!) 01:33, 11 January 2007 (UTC)

Do the words "irrespective of the duration of pregnancy" not explicity state that a stillbirth can occur before five months? You accuse me of "edit-warring", and yet I proposed the following language only once, and you have not explained why the last sentence is problematic at all:

"A stillbirth is usually defined medically as occurring when a fetus, of mid-second trimester to full term gestational age, which has died in the womb, or during labour or delivery, exits the maternal body. Governmental and medical organizations have sometimes used alternate definitions for statistical and other purposes. According to some sources, stillbirth is defined as fetal death irrespective of the duration of pregnancy. "

I don't think a bald accusation of edit-warring is any substitute for a cogent response. Additionally, if a dictionary says that stillbirth is synonymous with fetal death, then it is not "original research" to infer that some sources say stillbirth is synonymous with fetal death irrespective of other factors.

Just because you happen to prefer one of a plurality of medical definitions is no reason to shove it down everyone else's throat, accompanied by accusations of edit-warring and politicization. This article very obviously covers more than just medical issues. And note that Lyrl was not relying on medical sources for her understanding of the term. The definition at the top of the page should not narrowly prefer a particular medical definition.Ferrylodge 02:02, 11 January 2007 (UTC)

Today, I edited the page, and the edit was reverted. See here. Severa's objection is "original research" which I find manifestly implausible. Subsequently, I added yet another reference to the four I have already provided: Wictionary (“1. The birth of a dead fetus. The delivery of an infant which is dead at birth, regardless of stage of development”), retrieved January 11, 2007. Ferrylodge 23:44, 11 January 2007 (UTC)

This whole argument seems ridiculous to me. There are miscarriages and there are stillbirths. Ignoring the medical definition, in common parlance, these terms are NOT synonymous. If a woman gives birth to a dead baby, then we call that a stillbirth. If a woman is only pregnant for a few months and 'looses' the fetus, we call that a miscarriage (and loosing a fetus is not the same thing as giving birth). There is a grey area for sure, but medically, and commonly speaking, the terms have two distinct meanings. I think editors here need to watch out for WP:POINT. Don't disrupt wikipedia to prove a point. We don't need all those citations one after each other. Discuss it out here, and maybe we can reach a consensus and use the best citation. Ferrylodge, bring your sources here to the talk page, instead of flooding the main article with information more relevant to the content dispute going on here. All that said, I personally do not think the definition ferrylodge is pushing is very common, but I wouldn't oppose a sentence (worded differently) to point out that usage. I'll try my hand at rewording it. -Andrew c 01:40, 12 January 2007 (UTC)