Losing a baby at any stage of pregnancy is one of the most devastating and heartbreaking experiences a person can go through. Whether that loss happens early on or close to a baby's due date, the grief is real, the questions are many, and the need for clear, compassionate information is important.

If you have experienced pregnancy loss and are trying to make sense of what happened, or if you are supporting someone who has, this guide aims to explain the key differences between stillbirth and miscarriage in plain terms. We also set out what these experiences can look like medically and emotionally, and when medical negligence may have played a role.

If you believe that failures in your care contributed to the loss of your baby and would like to understand your options, please do not hesitate to contact our medical negligence team.

Are Miscarriages and Stillbirths the Same?

Miscarriage and stillbirth are not the same, though both involve the devastating loss of a pregnancy. 

A miscarriage is defined as the loss of a pregnancy before 24 weeks have passed. A stillbirth involves the death of a baby after 24 weeks, but before or during their delivery. 24 weeks is the determining factor because it is widely considered the point of “viability” - the point in a pregnancy when a baby can survive outside of the womb, often with medical support.

Those who suffer a miscarriage can apply for a baby loss certificate, whilst those who suffer a stillbirth can apply for a stillbirth certificate. 

This legal and medical distinction matters for a number of reasons beyond terminology, including entitlement to maternity leave and the formal recognition of the baby's existence. Many parents feel it important that their baby is recognised in this way.

Both experiences involve profound grief and, in some cases, they can raise questions about whether the care provided met the standard that parents have a right to expect.

What is a Miscarriage?

Miscarriage is fairly common with approximately 1 in 4 pregnancies ending in miscarriage. The majority happen in the first 12 weeks, often before a pregnancy is showing or has been widely shared with family members or friends.

Types of miscarriage

There are several types of miscarriage that a healthcare professional may refer to:

• Early miscarriage occurs in the first 12 weeks of pregnancy and accounts for the majority of pregnancy losses. The main cause of early miscarriage is a chromosomal abnormality, which leads to the baby not developing normally. This is not something that can be prevented or predicted.
• Late miscarriage refers to the loss of a pregnancy between 12 and 24 weeks. This is less common than early miscarriage and can sometimes be linked to pregnancy complications such as weakness of the cervix, infections, or problems with the placenta. A late miscarriage can be particularly difficult to process because by this point many parents will have shared the news, felt the baby move, and begun to prepare for life with a new child.
• Silent miscarriage (also called a missed miscarriage) is when the baby stops developing but the mother’s body has not yet recognised the loss. There may be no symptoms at all, and the pregnancy loss is generally only discovered during a routine scan. This can be particularly shocking for parents who have no reason to suspect that something has gone wrong.

Symptoms of miscarriage

Symptoms can vary depending on the type of miscarriage and how many weeks of pregnancy have passed. Common signs that a healthcare professional will look out for include:

• Vaginal bleeding, which can range from light spotting to heavy bleeding
• Cramping or pain in the lower abdomen
• The disappearance of symptoms associated with pregnancy, such as nausea
• The loss of fluid or tissue from the vagina

It is important to note that vaginal bleeding in early pregnancy does not always mean a miscarriage has occurred. However, any bleeding should be reported to a doctor or midwife promptly so that the situation can be properly assessed.

Causes of miscarriage

Whilst chromosomal abnormalities account for the majority of early miscarriages, other factors that can increase the risk of miscarriage include:

• Certain health conditions in the mother, such as diabetes or thyroid problems
• High blood pressure or other pregnancy complications
• Problems with the uterus or cervix
• Infections
• Age, with the risk increasing in pregnancies after 35
• A history of recurrent pregnancy loss, which places future pregnancies in a higher risk category

For many women who have experienced miscarriage, no clear cause will ever be found. It can feel deeply frustrating being left without answers. However, a high percentage of women who have experienced a miscarriage go on to have a subsequent healthy pregnancy.

Can miscarriage be a sign of medical negligence?

In most cases, miscarriage is not caused by failings in medical care. However, there are circumstances where a healthcare provider's actions or inactions may have contributed to a pregnancy loss. These can include:

• A failure to diagnose or adequately treat an infection during pregnancy
• A failure to identify or appropriately manage a pregnancy known to carry additional risk
• Inadequate monitoring despite a past history of previous complications in pregnancy. 
• Errors in treatment which cause direct harm to the mother or the developing baby

If you have suffered a miscarriage and believe that the care you received fell below the standard you were entitled to expect, it is worth speaking to a medical negligence solicitor about whether you may have grounds for a claim.

What Is a Stillbirth?

A stillbirth occurs after 24 weeks of pregnancy. In the UK, approximately 1 in 250 babies are stillborn.

It is worth taking this opportunity to quickly distinguishing between a stillbirth and a neonatal death, as the two terms are sometimes confused. A neonatal death involves the death of a live-born baby within the first 28 days of life. Both are forms of baby loss that can involve profound grief and, in some cases, questions about the standard of care provided. Neonatal death can be associated with complications during labour, problems arising from premature birth, or conditions that were not identified or managed appropriately before or after the birth. 

The experience of stillbirth

Every parent's experience of stillbirth is different, and there is no right or wrong way to feel or respond. Some parents choose to spend time with their baby after the birth. Some hospitals have ‘cold cots’ available for stillborn babies, giving their families time to hold them, take photographs as a way of creating memories, and hold religious ceremonies. 

Some parents describe the period around a stillbirth as one of profound disorientation. The physical process of labour and birth continues, but the expected joy at the end of it does not arrive. The psychological impact of this can be significant and long-lasting. Many parents experience grief, trauma, anxiety, and depression in the weeks, months and even years that follow. Some go on to develop post-traumatic stress disorder.

The loss of a baby through stillbirth is a deeply traumatic experience, and its effects are often felt long after the initial loss. Many parents find that the support of a counsellor or specialist bereavement service makes a meaningful difference.

Hospitals will typically offer a range of memory-making support, including photographs, handprints and mementoes. Bereavement midwives and specialist support workers are often available to guide parents through the process and ensure they have access to whatever help they need.

Causes of Stillbirth

Although stillbirth can occur without any prior warning signs, according to stats published by Tommy’s, a pregnancy and birth charity, a number of factors are known to increase the risk.

The most commonly identified causes of stillbirth include:

• Placental problems, including placental abruption (where the placenta separates from the uterine wall before birth), which accounts for between 10 and 20 per cent of stillbirths
• Umbilical cord complications, such as a twisted umbilical cord which is a factor in around 10 per cent of stillbirths
• Infections, which are a significant cause of stillbirths globally and can account for a large proportion of cases in developing countries, including up to 50 per cent in some regions
• Foetal growth restriction, where the baby does not grow as expected and may not receive adequate oxygen and nutrients via the placenta
• Pregnancy complications such as pre-eclampsia or gestational diabetes
• Chronic health conditions in the mother, which can increase the risk of serious complications during pregnancy

Where the cause cannot be established, this is sometimes referred to as an “unexplained foetal death”. One in three stillbirths have no clearly identified cause, even after thorough investigation. Never fully knowing why their baby was stillborn can often add even more trauma to the experience for many parents.

Risk factors for stillbirth

Certain factors can increase the likelihood of a baby being stillborn, including:

• Smoking during pregnancy
• Obesity, reinforcing the importance of maintaining a healthy weight during pregnancy
• Age, particularly in pregnancies involving older mothers
• Multiple pregnancies (twins, triplets, and so on)
• Previous pregnancy loss, which can place future pregnancies in a higher risk category
• Pre-existing conditions such as diabetes, lupus, or high blood pressure
• Reduced foetal movements (if you notice that your baby moves less than usual, contact your midwife or doctor immediately)

Mothers who have previously experienced baby loss, or who have ongoing health conditions, are often monitored more closely during subsequent pregnancies. If you feel that the level of monitoring you received did not reflect the risk factors present in your pregnancy, this may be worth raising with a healthcare professional or discussing with a solicitor.

The NHS has clear guidance on monitoring foetal movements and other warning signs during pregnancy. If you have any concerns, please speak to a healthcare professional without delay.

The Emotional Impact of Baby Loss

The emotional experience of pregnancy loss, whether through miscarriage or stillbirth, can be overwhelming. Many parents feel shock, profound sadness, anger, guilt, and isolation in the aftermath. It is important to know that all of these responses are valid, and that there is no right or wrong way to grieve.

Many parents who have experienced an earlier loss describe the grief as something that is not always understood by those around them. There can be a sense that because the baby was not yet born, or was not known to wider family members and friends, the loss is somehow less significant. This is not the case. Pregnancy loss at any stage is the loss of a child that was already loved.

Following a stillbirth in particular, long-term psychological distress is common. Parents may find it difficult to return to daily life, to contemplate future pregnancies, or to talk about what happened. Some find it hard to be around other families with healthy babies. These are all understandable responses, and there is no timeline for grief.

Many parents also find that the grief following a neonatal death feels different to the grief following a stillbirth, not because one loss is greater than another, but because the experiences themselves are so different. In neonatal death, parents may have had hours, days, or weeks with their baby before they died, which shapes the grief in its own particular way.

If you are struggling with the psychological impact of baby loss, please speak to your doctor about the support available to you. Specialist services exist to help parents navigate this incredibly difficult experience.

Medical Negligence and Pregnancy Loss

Not every miscarriage or stillbirth involves medical negligence. However, in some cases, failings in the care provided by a doctor, midwife, or other healthcare professional may have contributed to this or caused avoidable harm.

Examples of medical negligence in pregnancy that may lead to a claim include:

• Failure to identify or act on signs of foetal distress
• Inadequate monitoring of a pregnancy known to carry additional risk
• Failure to diagnose or treat an infection promptly
• Delayed or incorrect response to reduced foetal movements
• Failure to recognise and manage pregnancy complications such as pre-eclampsia
• Errors in interpreting scans or test results
• Poor management of labour where risk factors were already known
• Failures in neonatal care following the birth

Where a baby sadly dies shortly after birth as a result of poor care during labour or in the immediate neonatal period, parents may have grounds for a claim relating to neonatal death rather than a stillbirth claim. 

How do you know if you have grounds for a claim?

To bring a medical negligence claim, two things must be demonstrated:

• First, that the care you received fell below the standard expected of a reasonable body of healthcare professionals
• Second, that this failing directly caused the harm you experienced.

This is not always straightforward to establish, and it requires an independent review of your medical records by a specialist. At JMW, we begin by gathering evidence to build your case. This includes your own detailed account of your symptoms and appointments, copies of your medical records (which will detail the times you reported your symptoms and the healthcare professional's subsequent actions and treatment), and witness statements from anyone else who may have attended an appointment with you. Our legal team will gather all the necessary documentation to investigate the case and, depending on our review of the records, we will instruct independent medical experts to address the care you received and the impact of this. They will provide their opinion on whether a reasonable standard of care was met.

To learn more, take a look at our guide to the medical negligence claims process.

Time limits for making a claim

In England and Wales, the standard time limit for bringing a medical negligence claim is three years from the date of the incident, or from the date you first became aware (or reasonably should have become aware) that negligence may have occurred. This is known as the date of knowledge.

Given that the investigation process takes time, it is important to seek advice sooner rather than later. If you have concerns about whether a time limit applies to your situation, a clinical negligence solicitor will be able to advise you.