By Ruhie Jamshaid
Statistics show that approximately three per cent of all births in Pakistan are stillbirths. This is a relatively astounding figure; yet, much mystery surrounds the phenomenon of stillbirth. In a third of all the stillbirths, the causes are unidentified. Since some cases might not be reported, the occurrence of stillbirths might be higher in reality. Stillbirth is technically defined as the death of a foetus during the last trimester of pregnancy, specifically in the twentieth week or later. Only fourteen per cent of stillbirths occur during delivery, whereas the majority occur before. The death of a foetus at such a late stage may prove to be far more devastating for the mother and family than a miscarriage, as the baby is almost fully developed. Since by the last trimester the mother has also felt the movements of the child, the bond between her and the child is greater, as compared to a miscarriage.
There are several known causes of stillbirth:
Placental abruption: This is the most common cause of stillbirth, which occurs when the placenta strips away from the uterine wall resulting in the lack of oxygen for the foetus.
Chromosomal abnormalities: This is the main cause of early miscarriages. However, death of the foetus can occur at any time during the pregnancy due to chromosomal abnormalities.
Protein-S deficiency: Protein-S is a protein required to avoid blood clots. In a small percentage of pregnant women, the level of protein-S can suddenly drop during pregnancy, resulting in the clotting of blood in the umbilical cord. This can block oxygen transfer to the foetus.
Environmental factors: Malnutrition of the mother, bacterial infections (for example, listeriosis), growth retardation, cord that is tied around the neck of the foetus and physical shock can all lead to foetal death. Despite some known reasons for stillbirth, there are cases, when the cause of stillbirth remains unknown, due to no obvious signs or indications.
Pregnant women can take some precautions to lessen the possibility of stillbirth, such as balanced nutrition during pregnancy. Iodine deficiency, for example, is a known cause of stillbirth. Healthy food and good rest go a long way in safeguarding the baby.
Going for regular prenatal check-ups is also essential, especially if it is a high-risk pregnancy. Careful monitoring of a high-risk pregnancy helps to avoid stillbirth.
Monitoring the foetal movement is perhaps the best way to ensure that the baby is doing fine. After the twenty-fifth week, the pregnant mother can count the number of kicks. If ten or less kicks are recorded in a single day, help from a healthcare provider should be sought immediately.
One way to monitor the baby’s health at home is to invest in a foetal heart monitor. This allows us to ensure the presence of a heartbeat at our convenience.
Sometimes, even despite the best efforts and care, a stillbirth can still occur. In such cases, it is important to go through the grieving period. For Muslims, having a proper burial gives the family a sense of closure. The grave of the child can serve as physical means for remembering the child. Even naming the child before burial helps the grieving family and serves in appeasing them. The family can feel comforted in the fact that they have fulfilled all their duties towards the child. Reading Surah Al-Fathiha and other Surahs of the Quran are also beneficial to the entire grieving process.
For us, as Muslims, it is important to put our faith in Allah (swt) and understand that life and death are solely in His hands. Understanding this can help us psychologically. It is also possible to try for another child, if Allah (swt) wills so. Keeping a positive outlook and faith in Allah (swt) will give the family of the deceased child the necessary strength for going through the grieving process.