Birth Plan After Stillbirth or Pregnancy Loss

If you are reading this because your baby has died, or because you have been told your baby may not live long after birth, we are so sorry. This page sets out the choices you may be offered, in plain words, so you can think about what feels right for you. There is no right or wrong way to do this.

You do not have to read it all at once, and you do not have to decide everything now. Your midwife, nurse, or doctor can go through it with you. Many hospitals have a specialist bereavement midwife or nurse whose role is to support families through exactly this, and it is always fine to ask for them.

It Is OK to Make Choices, Even in Shock

Many parents say that in the first hours after hearing their baby has died, it felt impossible to think. That is a normal response. Even so, some parents later say they are glad they had a say in things like who was with them, how long they spent with their baby, and what memories they kept.

• You can ask for time before making decisions, and for information to be repeated or written down.
• You can say "I don't know yet" and come back to a question later.
• You can change your mind. Something you said no to at first, such as seeing or holding your baby, can often still be offered later.
• You can ask someone you trust to help you think, or to speak for you.

Timing and Options for Birth

When a baby has died in the womb later in pregnancy, they still need to be born. Your care team will explain the options that are safe for you, which depend on your health, how many weeks pregnant you are, and your previous births.

Induction or Waiting for Labor

• Induction: Labor is started with medication, usually tablets and sometimes other methods. Some people choose to go home for a short time after taking the first medication and come back to give birth.
• Waiting for labor to start: If you are physically well and your waters have not broken, you may be able to go home and wait for labor to begin naturally for a time. Waiting too long can carry risks for your health, such as infection or problems with blood clotting, so your team will check on you and advise you about how long is reasonable.
• Going home first: Unless there is a medical reason to act quickly, many families are offered the chance to go home for a while, to be together, gather things, and tell family, before coming back.

Vaginal Birth or Cesarean

It is natural to want this to be over as quickly as possible, and many parents ask for a cesarean. Professional guidance, such as that from the Royal College of Obstetricians and Gynaecologists (RCOG), generally recommends vaginal birth for most people in this situation. A cesarean is major surgery that can mean a longer physical recovery and may affect future pregnancies, and it does not change the outcome for your baby.

A cesarean is sometimes the right choice for medical reasons, for example depending on your health or previous surgery on your uterus. If you want to talk about it, please do. Ask your care team to explain the benefits and risks for you specifically.

Labor and Pain Relief

You can have the same range of pain relief as in any other birth, including an epidural where available. Some parents want to feel as little as possible; others want to be as present as they can. Either is completely understandable.

• Say whether you'd like pain relief offered early, or only when you ask
• Say whether you'd like staff to explain each step, or keep talk to a minimum
• Ask for music, dim lights, or quiet if that would help
• Ask whether your partner or support person can stay with you the whole time

More detail on each option is in our guide to pain management options.

Who Is With You

• Who you would like present during labor and birth, and who you would prefer not to be there
• Whether you'd like family members, such as grandparents or your other children, to come in afterward to meet the baby
• Whether you would like a doula, faith leader, or friend with you
• Whether you'd like the same midwife or nurse throughout, where possible

Meeting and Holding Your Baby

There is no right amount of time and no right way to feel. Some parents want their baby placed on their chest straight away; others would rather the baby is wrapped first, or would like staff to describe how the baby looks before they see them. Some decide not to see their baby, and that is also a valid choice.

• Whether you would like to hold your baby immediately, or after they have been wrapped
• Whether you'd like staff to tell you what to expect about your baby's appearance first
• How long you'd like to spend with your baby; many hospitals allow hours or days, and you can ask for more time
• Whether your baby can stay in the room with you

Many hospitals have a cooling cot (sometimes known by the brand name CuddleCot), which keeps your baby cool so you can have more time together. In some places, it may be possible to take your baby home for a time before the funeral; ask your bereavement midwife or nurse what is possible locally.

Making Memories

You may not feel ready to think about this now, but some parents later treasure the memories they gathered. You can ask staff to collect keepsakes for you to keep safely in case you want them later.

• Photographs: Your own photos, photos taken by staff, or photos from a volunteer bereavement photographer. Organizations such as Now I Lay Me Down to Sleep (US and other countries) and Remember My Baby (UK) connect families with volunteer photographers at no charge. You can ask the hospital whether they can contact one for you.
• Hand and footprints: Ink prints or casts of your baby's hands and feet
• A lock of hair, if your baby has hair
• Name bands, cot card, and the blanket or clothes your baby was wrapped in
• A memory box: Many hospitals provide one, often donated by a charity
• Matching keepsakes: Some families keep one small toy or blanket with their baby and take a matching one home
• Letters, readings, or recordings, such as reading a story or singing to your baby

Naming, Bathing, and Dressing

• You can give your baby a name and ask staff to use it
• You can bathe your baby yourself, with help, or ask staff to do it
• You can dress your baby in clothes you choose, or in clothes the hospital provides; some hospitals and charities keep small outfits for babies born early
• You can decide who holds your baby and when

Spiritual and Cultural Wishes

Tell your care team about any religious or cultural practices that matter to you, such as a blessing, naming ceremony, prayers, or particular ways of washing and caring for your baby. Hospitals usually have chaplains or can contact a faith leader for you. If there are traditions around timing of a funeral, let the team know early so tests and paperwork can take this into account where possible.

Tests and Post-Mortem (Autopsy) Choices

You will likely be offered tests to try to understand why your baby died. These may include blood tests for you, examination of the placenta, and a post-mortem examination (autopsy) of your baby. Sometimes a cause is found, and sometimes it is not.

• A full post-mortem, a limited one, or an external examination only may be offered
• You can ask what each option involves, how your baby will be cared for, and how long it may take before results are ready
• You usually do not have to decide during labor or straight after the birth. Ask how long you have to decide
• You can say no, and you can ask for a follow-up appointment to go through any results

Your Room and How Staff Know

• Ask for a room away from the sounds of other babies, or a dedicated bereavement suite if the hospital has one
• Many hospitals put a small symbol on the door, such as a butterfly, leaf, or teardrop card, so every member of staff who comes in knows your baby has died; ask if this can be used for you
• Ask for a note on your records so you are not asked routine questions about your baby later on
• Ask whether your partner can stay overnight with you

Lactation After Loss

Your body may produce milk after the birth, including after a loss in the second trimester. This can be very painful, physically and emotionally, and it helps to know in advance.

• Letting milk settle: A supportive bra, cool compresses, and pain relief can ease discomfort while your supply reduces. Expressing a small amount for comfort may help
• Medication: In some cases, medication to stop milk production may be offered. Ask whether it is suitable for you
• Donating milk: Some parents choose to express and donate milk to a milk bank for babies in neonatal care. Ask your team whether there is a milk bank nearby that accepts donations from bereaved parents
• Some parents like to keep a small amount of milk, or have it made into a keepsake

Going Home and Aftercare

• Ask how you will be supported at home, and whether a midwife, nurse, or bereavement specialist will contact you or visit
• Ask which physical warning signs to watch for, such as heavy bleeding, fever, or pain that is getting worse, and who to call
• Ask about paperwork, such as registering the birth and death certificates, which varies by country and by how many weeks pregnant you were; the hospital can explain what applies to you
• Ask about funeral, cremation, or burial options, including any help the hospital offers. You do not need to rush this decision
• Ask for a follow-up appointment to go through test results and talk about what happened
• Ask for antenatal clinics and baby-related mailings to be cancelled, where possible

Support for Partners and Siblings

Partners are grieving too, and are often also trying to look after everyone else. It can help to name a friend or family member who can handle phone calls, messages, and practical tasks.

If you have other children, you know them best. Some families bring children in to meet their sibling; others prefer to share photos or keepsakes later. Plain, honest words suited to a child's age are usually gentler than phrases like "gone to sleep", which can be confusing. Your bereavement midwife or nurse, or the organizations below, can suggest books and resources for children.

Sample Bereavement Birth Plan

This example is only a starting point. Include only what matters to you, and leave out anything you haven't decided. You can print this page to take to your care team.

If Your Baby Is Expected to Live Only a Short Time

If you have been told that your baby has a life-limiting condition, you may be offered perinatal palliative care (sometimes called comfort care). This focuses on your baby's comfort and on your family's time together. A birth plan in this situation often includes:

• Whether you would like continuous monitoring of the baby's heart rate in labor, and whether you would consider a cesarean for the baby's sake if problems arise. Your care team can explain what each choice would mean in your situation
• What care you would like for your baby after birth: comfort measures such as warmth, holding, and feeding if possible, and your wishes about resuscitation and other treatments
• Who you would like to meet your baby while they are alive, and any blessing or ceremony you would like soon after birth
• Where you would like to spend your time together, such as in your room, and whether going home or to a children's hospice is possible
• Memory-making, as above, which some families begin before birth

Ask whether your hospital has a perinatal palliative care team or a children's hospice it works with. These plans are usually made over several appointments and can change as you learn more.

Support

The first place to ask for help is your hospital's bereavement midwife or nurse, who can put you in touch with local services, counseling, and parent groups. You can also contact organizations that support families after the death of a baby, including:

• Sands (UK): support for anyone affected by the death of a baby, including a helpline and local groups
• Tommy's (UK): information and support after pregnancy loss and stillbirth
• Star Legacy Foundation (US): stillbirth education and family support
• Return to Zero: HOPE (US): resources and support for families after pregnancy and infant loss
• Share Pregnancy & Infant Loss Support (US): support for families after pregnancy loss, stillbirth, or infant death
• Now I Lay Me Down to Sleep (US) and Remember My Baby (UK): volunteer remembrance photography

If you feel unable to cope or have thoughts of harming yourself, please contact your doctor, midwife, or local emergency services straight away. In the US you can call or text 988 (Suicide & Crisis Lifeline); in the UK and Ireland you can call Samaritans free on 116 123, day or night.

Frequently Asked Questions

You can print this page to take to your care team. Your midwife, nurse, or bereavement specialist can help you turn it into a plan that fits your hospital and your family.