The loss of a baby in the final weeks of pregnancy is a heartbreaking and devastating experience. When a stillbirth occurs after 37 weeks of pregnancy, it is classified as a full-term stillbirth. Whilst these are relatively rare, there are several risk factors and circumstances that can make them more likely. Midwives, doctors and other members of your pregnancy care team should also be aware of the risks and take action to prevent stillbirth wherever possible.

Most stillbirths occur due to natural complications, but when they are related to how a healthcare provider managed the pregnancy and delivered your care, you may be entitled to compensation. Whilst medical negligence is only one reason that stillbirths happen, it means that you may be able to claim for the physical pain, psychological harm, and financial losses caused by a stillbirth.

JMW provides expert legal support to families who want to investigate the causes of stillbirth and establish whether medical negligence played a role. Here, our stillbirth compensation solicitors outline some of the potential causes of a full-term stillbirth, explain when medical negligence can be a factor, and discuss the legal options that families have when they learn that mistakes were made.

Common Causes of Stillbirth at Full Term

Statistics from Tommy’s indicate that around one in every 250 births in England and Wales results in stillbirth. When babies sadly die in this way, investigations into the causes can involve blood tests, genetic tests, and an examination of the placenta to determine the underlying cause. However, there are risk factors that can make a stillbirth more likely, and these should be identified by doctors and treated effectively to increase the chances of the baby being delivered safely. Causes of stillbirth that may be identified by doctors early in pregnancy include:

Placental problems

Placental problems are the cause of many stillbirths, according to the NHS. The placenta is the life support system for the baby, and provides oxygen and nutrients that the fetus needs to grow and develop. If it is not working properly, the baby's growth may be restricted, or they may not receive enough oxygen. Fetal growth restriction can happen when the placenta fails to function properly, which prevents the baby from reaching its full growth potential. Fetal growth restriction carries a higher than normal risk of stillbirth.

Placental abruption is a serious condition where the placenta separates from the uterus before birth. This occurs in 10 per cent to 20 per cent of stillbirths and causes heavy bleeding, which can be fatal for the baby. If the placenta separates, the baby's blood supply is immediately compromised. These conditions often demand emergency treatment to protect the mother and maximise the baby's chance of survival. If doctors misdiagnose the problem or fail to act, this could mean that medical negligence contributed to a stillbirth.

Umbilical cord complications

The umbilical cord supplies the baby with oxygen and nutrients. Any umbilical cord problem that obstructs this flow can lead to a stillbirth at full term. One such complication is cord prolapse, where the cord slips into the birth canal ahead of the baby which can result in it becoming compressed.

Whilst umbilical cord accidents are relatively rare, knots in the cord or the cord becoming tightly wrapped around the baby can obstruct oxygen flow and blood supply to the fetus almost instantly. If the umbilical cord is not providing what the baby needs, the risk of stillbirth increases significantly in the final weeks.

Pre-eclampsia

Pre-eclampsia is a condition that affects the placenta. Key signs include high blood pressure, high levels of protein in urine, severe headache, visual disturbance, and the sudden swelling of the hands and feet. Pre-eclampsia increases the risk of stillbirth after 20 weeks because it limits the blood supply to the uterus. It is essential that healthcare providers monitor a woman’s blood pressure and protein levels in urine to catch this early. If not sufficiently managed, pre-eclampsia can lead to placental abruption or the need for an emergency caesarean section to save the baby.

Gestational diabetes

Gestational diabetes is a temporary type of high blood sugar that develops during pregnancy, and goes away after the birth. If not controlled, it can cause the baby to grow too large, increasing the risk of birth complications and stillbirth. A healthcare provider should offer screening for this condition, especially if the mother has specific risk factors such as a high BMI or a family history of diabetes.

Are There Warning Signs of a Stillbirth that Doctors Should Look For?

Many stillbirths happen after warning signs go unnoticed or unaddressed by doctors. Fetal movement is one of the most reliable indicators of a baby’s health. If a baby's movements slow down, change or stop, it may indicate that the baby is in distress or that the baby's blood supply is compromised. Altered fetal movements should always be checked by a midwife or a doctor. 

Other symptoms that require immediate investigation include:

• Vaginal bleeding (which may suggest the placenta has separated from the uterus).
• Severe abdominal pain.
• Sudden swelling of the hands, feet, or face
• Severe headaches (signs of pre-eclampsia)
• Itching, particularly on the palms of the hands and soles of the feet (a sign of a liver disorder called intrahepatic cholestasis)

Doctors and midwives must treat any report of reduced fetal movements as an emergency, along with any reports by the mother of any of the above symptoms. Sadly, sometimes a mother’s concerns may be dismissed. If doctors do not respond to these signs, whether by offering treatment or recommending an emergency caesarean section rather than a vaginal birth, and you experience a stillbirth as a result, you may be entitled to make a claim.

What Should Doctors Do to Prevent Stillbirths?

Medical professionals have a duty to monitor both the mother and baby throughout the pregnancy. To prevent stillbirth, the care team should:

• Perform regular scans: Monitoring the baby's growth via ultrasound helps identify fetal growth restriction early.
• Conduct blood tests: Regular screening can detect gestational diabetes and high blood pressure.
• Assess risk factors: Identifying women at higher risk allows for more intensive monitoring and earlier intervention.
• Manage the delivery: If a baby is at risk, an induced labour or a caesarean section may be necessary before the due date to ensure a safe birth.

Negligence may arise when the medical team does not fulfil its responsibilities as described above. This could include scenarios where:

• The care team ignored reports of reduced fetal movements.
• There was a delay in performing an emergency caesarean section.
• High blood pressure or other signs of pre-eclampsia were not monitored or treated correctly.
• Fetal growth restriction was missed on ultrasound scans.
• Genetic conditions were not identified through standard screening.

However, these are not the only circumstances where you may be entitled to claim. Factors like regular monitoring of fetal movements and baby's growth represent the baseline of professional care, and any errors in this area could lead to a medical negligence claim.