Stillbirth is medically defined as the death of a fetus at or after 20 completed weeks of gestation. Families often seek clear, factual information regarding the physical state of their stillborn baby. This article provides specific information about the natural post-mortem changes that occur. Understanding these changes helps manage expectations, allowing parents to focus on connection and love during the time spent with their child.
Understanding Rigidity: What is Rigor Mortis?
Stiffness, known as rigor mortis, is a common concern and does occur in stillborn babies. This temporary post-mortem change is caused by a biochemical process in the muscles. After death, the lack of oxygen depletes adenosine triphosphate (ATP), the energy molecule required for muscle relaxation. Without ATP, muscle fibers remain locked in a contracted state, causing stiffness.
Due to smaller muscle mass, rigor mortis in infants generally has an earlier onset and a more rapid disappearance than in adults. While the stiffness may be less pronounced, it will still be present. The rigidity is not permanent and resolves as decomposition processes begin.
Other Observed Physical Characteristics
Parents may observe several other physical changes, particularly if fetal death occurred days before delivery. The baby will feel cool to the touch since the body is no longer generating heat. The skin often shows a generalized pallor or a reddish-purple discoloration in dependent areas where blood has settled, known as livor mortis.
If the baby remained in the womb for days after death, the skin may exhibit maceration, which is the softening and peeling of the outer layer. This occurs because the skin was saturated in amniotic fluid without the protective layers of a living baby. The peeling can range from minor slippage to more extensive separation, exposing a moist, reddish surface underneath.
Timeline of Post-Mortem Changes
The timing of post-mortem changes in a stillborn baby is often accelerated compared to an adult. Rigor mortis can set in quickly, sometimes becoming noticeable within 30 minutes to a few hours after death, and typically becomes complete within 8 to 12 hours.
Rigidity remains for a period before resolving, usually within 24 to 48 hours, depending heavily on the environmental temperature. Healthcare providers use cooling measures, such as cooling blankets, to slow down these processes. Maintaining a cool environment helps preserve the baby’s appearance and extends the window of time parents have to interact with their child.
Preparing for Viewing and Memory Making
Hospitals and care teams take specific actions to prepare a stillborn baby, aiming to minimize the visual impact of post-mortem changes for the parents. They often bathe and dress the baby, carefully swaddling them in a blanket to make the baby look as peaceful as possible. If skin changes are present, swaddling can also help to cover areas affected by maceration.
The opportunity to see and hold the baby is a chance for parents to create tangible memories, which is a deeply personal choice. Memory-making activities are strongly encouraged and can include taking photographs, creating molds of the baby’s hands and feet, and saving a lock of hair. Knowing about the potential for coolness or stiffness allows parents to focus on connection and love.