KNOW YOUR NORMAL
Just as no two children are alike, no two pregnancies are either. (If you've been pregnant more than once, you can likely attest to that!) That's why it's *so crucial* to know what is normal for your pregnancy, your baby, and your body.
The other key aspect to #KnowYourNormal is trusting your intuition. Pediatricians have been trained for decades to take parents' (and their own!) instincts into account when diagnosing a child - and guess where that intuition starts? You got it: during pregnancy.
Getting to Know Your Baby
Whether you are 4 weeks pregnant or 40, you are a parent already! And nobody knows your baby or your body better than you.
Being pregnant can be a difficult experience in many respects, but having a front-row seat to your baby's personality is one of the biggest perks! Paying close attention to your baby's behavior - their usual patterns of activity, what stimuli they respond to, their typical style of movement, etc. (see #MovementsMatter) - is a great way to bond with your child, and an opportunity no one else gets to enjoy quite like you do. So take advantage of that!
You Know Your Body Best
Every pregnancy is different. It's critical to know what's normal for you and to always speak up if you notice a change (see #AlwaysAsk).
Learn the urgent maternal warning signs (for both during pregnancy and a up to a full year after delivery) - handy graphic from the CDC below (multiple languages available!) - and know your stillbirth risk factors.
Your baby may be more vulnerable to stillbirth if you:
Are pregnant for the first time
Delivered by c-section in a previous pregnancy
Identify as BIPOC, especially if you are Black (see Birth Equity & Racism)
Are age 35 or over (see 35+ Pregnancy)
Identify as LGBTQ+ (see LGBTQ+ Parents)
Are pregnant with twins/multiples
Have health conditions such as high blood pressure, diabetes, obesity, clotting disorders, hypothyroidism, etc.
Are a smoker or use drugs
If any of the above risk factors for stillbirth apply to you, be sure to make sure your medical provider is aware and ask your provider what you can do to lower your risks and if there are any warning signs in particular you should look out for.
But remember: stillbirth can happen even in healthy, low-risk pregnancies where none of these risk factors are present. (Just ask almost anyone on the PUSH team.) That's why it's critical to #KnowYourNormal and #AlwaysAsk if you ever have any concerns!
Trust Your Instincts
Sometimes you can't quite put your finger on what feels "off," but that's okay! That doesn't mean your instincts are wrong. It never hurts to follow up (see #AlwaysAsk) with your healthcare provider or go in for a quick checkup.
After all, your doctors are trained to rely on *their* intuition (they even have a fancy name for it!), so they should value yours as well! In fact, the National Health Service in the UK recently issued guidelines that any mother who comes in to get checked out for concerns about a change in her baby's movements qualifies for an ultrasound evaluation solely on the basis of "the midwife, obstetrician or woman herself [not feeling] reassured by the initial assessment."
Evidence for Maternal 'Gut Instincts'
Utilizing mother's intuition to identify at-risk pregnancies and prevent stillbirths is an area of emerging research, so there is not an abundance of data (yet!).
That being said, the evidence that *has* been documented so far definitely points toward a need for further study. For example, in one study of over 1,600 recently pregnant mothers, 65% of the moms whose pregnancies ended in a stillbirth reported that they had had a "gut instinct" that something was wrong, compared to only 12% of the moms who did not lose their baby.
As the authors of the study note, "women who have experienced a stillbirth had a gut instinct that things may be amiss with the pregnancy... with many recalling having these feelings from the beginning of their pregnancy and mentioning this to others well before their baby’s death." (Anecdotally, many members of the PUSH team who lost a baby to stillbirth can confirm that we experienced this as well.)
Of course, as the authors also point out, since this was a retrospective study (mothers reported their past experiences after their baby's birth) some "recall and negativity biases are very likely at play with respect to this finding." Again, more research needs to be done. But keeping this all in mind, to be on the safe side we encourage families to #AlwaysAsk your healthcare provider if you ever have any concerns about your baby or your pregnancy - even if you can't quite put those concerns into words.