Diagnosis: "No heartbeat detected"
Receiving the diagnosis that your baby’s heart has stopped beating can be emotionally overwhelming. If the loss occurs after the 13th week of gestation, surgical evacuation (curettage) is often no longer the preferred option. In most cases, the baby must be delivered vaginally.
1. Expectant management (Watchful waiting)
If you need time to process this situation emotionally, you may consider delaying delivery. Discuss this option with your obstetrician. Immediate induction is only medically necessary in specific cases (e.g. signs of infection or maternal risk).
- You must be closely monitored by a physician or midwife during this time to ensure your health status allows continued expectant management.
- If you experience fever, severe pain, or persistent heavy bleeding, seek medical care immediately.
2. Medical induction of labour
Labour may be induced using pharmacological agents. The medication regimen can be discussed with your attending physician, as multiple protocols exist.
- This method may be associated with stronger uterine cramps and heavier bleeding than expectant management.
- It is effective in most cases and can often be performed in an outpatient setting, depending on your condition.
- Regular medical supervision is important to detect and manage potential complications.
3. Postpartum uterine evacuation (Curettage)
Following delivery, retained placental tissue or endometrial remnants may necessitate a surgical procedure (e.g. suction or sharp curettage).
- This is typically performed under general anaesthesia, either outpatient or inpatient.
- Risks are low, but include infection and uterine injury.
- Please consult your midwife or obstetrician about the timing and necessity of this procedure—immediate intervention is not always required.
Important Notes
The process of labour can be prolonged, and the emotional burden of delivering a deceased child may intensify feelings of anxiety and distress. Writing down your thoughts and emotions during this time may support psychological processing and inner resilience. It is your baby—you are allowed to hold, touch, and love your child after birth.