Physical effects of a stillbirth

Many people have told us that the emotional trauma of shock and grief are far worse than the physical effects of stillbirth, but others found that the physical issues were as difficult to cope with. Try to remember that your body is recovering after the birth, which can be very difficult to deal with. 

Some people have told us that they wish they’d been told that their body won’t realise that their baby has died, and you will experience many of the ‘normal’ post-birth symptoms such as your breast milk coming in. 

The hospital will tell your GP, community midwife and health visitor what has happened so they can offer you care and support once you are home.

If you haven’t heard from your GP within a few days, phone your surgery to arrange to see someone. You might want to ask your GP to put a note on your record so it is clear for anyone else you speak to in the future.

Although it may be difficult, it is important to ensure you attend all your post-natal appointments. It might help to call your GP and find out in advance of appointments what will happen so you can prepare yourself.

Read more about postnatal care after a stillbirth.

These are some of the common physical changes that you might experience after giving birth.

Your breasts and breastmilk

Breastmilk is produced when your hormones drop after having a baby. Your breasts will still produce breast milk after giving birth to your stillborn baby. This can be very emotionally distressing and feel very unfair.

Breast engorgement, sometimes referred to as ‘milk coming in’, happens when your breasts fill with milk in the first few days after the birth. It can make your breasts feel very large, tight, painful and tender.

Suppressing breastmilk

It is possible to reduce the symptoms of engorgement and gradually the amount of milk you produce. You could try:

• applying ice packs (or a bag of frozen peas) covered in a light cloth to the breasts to get relief 
• wearing a well-fitting bra 
• putting chilled cabbage leaves on your breasts to reduce the pain and swelling (there isn’t a lot of evidence that this works but helps some people)
• put warm flannels on your breasts just before hand expressing if they are leaking
• using pain relief such as ibuprofen or paracetamol
• expressing small amounts by hand, just enough to ease the pain, otherwise you will encourage the production of more milk
• trying warm showers, which may encourage the breasts to leak naturally. 

You may find it helpful to wear breast pads for the first few days if you find you’re leaking milk.

Using medication to suppress milk 

You may prefer to use medication to suppress breastmilk instead of waiting for it to slow down and stop naturally. There medicines are called dopamine agonists, which stop your breasts producing milk (suppressants). However, you cannot take these if you had pre-eclampsia or high blood pressure. Talk to your doctor about the side effects of these medications.

“I was given this medication as part of my hospitals protocol of managing stillbirth. I was very grateful to be given it early on and had no symptoms of my milk coming in which I think I would have found very distressing.”
Kathryn

Donating breast milk

If you’d like to, there is the option of donating your milk to the UK National Milk Bank. Donated breastmilk helps other babies whose mothers are unable to give breastmilk. When a mother is unable to give any or enough of her own breastmilk for premature and sick babies, donor breastmilk is preferred to infant formula as it contains antibodies to fight infection. 

After-pains/stomach cramps

It’s common to have after-pains after giving birth. They can feel similar to labour contractions, cramps or strong period pains. This is your womb contracting back to its normal size and usual location (down inside your pelvis). Painkillers can help with this.

Bleeding (lochia) 

After the birth, you will bleed heavily through the vagina. This is called lochia and it is your body getting rid of the lining of your womb and blood from where your placenta was attached. Everyone is different, but for most it will be heavy for around 2 weeks and then will be lighter until around 6 weeks after the birth. At the start, it may have some lumps or small clots in it. It changes colour from red, to pink, to brown. The flow of this blood loss can increase and decrease, so don’t worry if your bleeding was easing off, but then looks heavier the next day. This is normal.

To start with, the bleeding will be heavy and you will need very absorbent sanitary pads. It’s best not to use tampons until after your 6-week postnatal check because they can cause infection.

If you find you’re losing blood in large clots, let your midwife know. If you’re filling a large sanitary pad in 1 to 2 hours or if you are passing blood clots larger than a £2 coin, please contact your local maternity unit as you may need to be checked.

Stitches 

You may have some painful stitches if you had tearing or an episiotomy (cut) during the birth. Bathe in clean, warm water to help you heal. Dry the area carefully afterwards.

• It can help to have a jug of water on hand (in the toilet) so you can clean and cool the area after having a wee.
• Don’t avoid going to the toilet to do a poo. Even if it feels like they will, the stitches are very unlikely to break. 
• In the first few days, take care when sitting down and lie on your side rather than on your back.
• Stitches usually dissolve by the time the cut or tear has healed.
• Take painkillers according to the instructions on the pack.

If you have any concerns about infections or healing, speak to your midwife, maternity unit or GP. 

Going to the toilet 

It can be worrying going to the toilet after giving birth because of fear of the pain, worry about the stitches breaking and the lack of sensation, or control. Although you might want to put off having a poo in case it hurts, try not to get constipated. Eat lots of fresh fruit and vegetables, wholegrain cereals and bread. Drink lots of fluids to keep your urine diluted and your poo softer.

It might give you confidence to hold a clean pad of tissues over the stitches while you do a poo. But try not to worry, it’s very unlikely that going to the toilet will affect your stitches. If you’re constipated, ask your midwife about which stool softeners or laxatives you can get to help you to do a poo more comfortably.

Piles 

Piles (haemorrhoids) are common after any birth and they tend to go after a few days. Make sure you drink lots of water and get plenty of fibre by eating plenty of fruit, vegetables and wholegrains. You need to avoid getting constipated and straining.

If you are worried, or very uncomfortable, talk to your midwife or GP about getting some ointment to soothe the area.

Your pelvic floor 

Your pelvic floor holds your pelvic organs (bladder, womb, bowel and vagina) in place. Its muscles give you control when you go for a wee, supporting your bladder and bowel. You might feel like you have little control of your body in the days after giving birth because your pelvic floor has weakened. If you trypelvic floor exercises (where you squeeze and hold the muscles like you are holding in a wee), you might find you have no sensation at all. Don’t worry, it should come back. It usually just takes time.

Your tummy will feel baggy and it will take time for your bump to go down. You may struggle to control your bladder, especially when you cough or move suddenly. It will get better with time, especially if you regularly do pelvic floor exercises.

If, after 3 months, you’re not seeing improvements with bladder control, you may need a referral to a physiotherapist.

The Pelvic Obstetric and Gynaecological Physiotherapy has a detailed booklet about exercise after a stillbirth, which you may find useful. 

Recovering from a caesarean section 

A c-section is major surgery. You’ll need to take time to recover and allow your wound to heal. 

If you had a caesarean section, you’ll usually need to stay in hospital for 2 to 3 days. You may be able to go home sooner if you’re doing well. 

You will feel uncomfortable and be offered painkillers. You may be prescribed daily injections to prevent blood clots (thrombosis).

Staff will encourage you to get mobile by getting out of bed and walking as soon as possible. They can offer advice on postnatal exercises to help you recover.

When you're well enough to go home, you'll need to arrange for someone to give you a lift as you will not be able to drive for a few weeks afterwards. 

There are different types of wound dressings. Ask your midwife how long your dressing will stay on for. Some are for 1 to 2 days, and others are for 5 days. Once your dressing has been removed, you’ll need to look after your wound by gently cleaning it and drying it every day. Your midwife will explain how to care for your wound and manage any pain. Please get in touch with your GP if you have any concerns about this or see signs of infection.

Getting a period after a stillbirth 

It is hard to say when your first normal period will happen after giving birth.

It’s likely it will be about 4 to 6 weeks after giving birth. However, because of the timing, it can be hard to know whether it is the post-birth lochia, or your first period.

Sometimes your first period isn’t like your normal period. Everyone is different. You might find your first period particularly difficult to cope with, and periods after this one too. This is totally understandable.

Read more about postnatal appointments and your 6-week check.  

Your feelings about your body after a stillbirth

Some people have told us that they felt disappointed and angry at their bodies for not ‘doing what they were supposed to’. If you feel this way, please speak to your healthcare team as they will be able to help you process your feelings and find support for you.