Clinical update

Pregnancy loss and the death of a baby

Charity Sands offers professionals guidance on pregnancy loss and the death of a baby.

Charity Sands offers professionals guidance on pregnancy loss and the death of a baby.


Over 100 babies die every week in the UK, and those at highest
risk are those with poor growth that is not picked up during pregnancy. Picture: Alamy

Essential facts

While rates of stillbirth are gradually declining, it is not a rare event. Over 100 babies die every week in the UK, just before, during or after birth.

More than 1,500 babies a year die in the first four weeks of life, many from congenital abnormalities or after being born prematurely.

Every year, 500 babies die from a labour-related event (some are stillbirths, some die neonatally). The death of a baby has a profound and lasting impact on parents and the wider family.

What’s new

Updated guidance for healthcare professionals caring for parents who lose babies at any stage during pregnancy or shortly after birth have been published by the charity Sands.

The fourth edition of Pregnancy Loss and the Death of a Baby: Guidelines for Professionals includes advice on early and late miscarriage, termination for fetal anomaly, stillbirth, care for ill babies and those who are likely to die shortly after birth.

The guidelines are well-recognised as the benchmark for good practice in bereavement care. 

Signs/symptoms

Stillbirth is defined by Sands as the death of a baby during pregnancy or birth any time from 24 weeks of pregnancy onwards. A neonatal death is the death of a baby within the first 4 weeks of life. 

Causes/risk factors

Risk factors for stillbirth include smoking, obesity, higher maternal age, multiple and twin pregnancies and teenage mothers.

Women with some medical conditions, especially diabetes, hypertension and thrombophilia, women with a past history of obstetric complications, and women from socially deprived areas and from some ethnic minority groups are also at higher risk.

Babies at highest risk are those with poor growth that is not picked up during pregnancy. For around a third of stillbirths, the cause is not known. Substandard care during labour can contribute to deaths.

How you can help your patient

Parents and their baby should always be treated with respect and dignity. Provide sensitive, empathetic care, acknowledging their loss and using the baby’s name.

Avoid making assumptions about what parents might or might not want based on their personal, cultural or religious beliefs or based on the way in which they are reacting to their loss.

Expert comment

University Hospitals Coventry and Warwickshire NHS Trust bereavement support specialist midwife Sam Collinge: 

'Sadly, pregnancy loss and the death of a baby is not a rare tragedy. It is a misunderstood type of loss that may leave parents feeling isolated and unsupported. Good communication is one of the most important aspects of good bereavement care.

'This involves listening to parents, sensitively offering choices regarding what will happen to them and their baby, and ensuring that they receive clear, concise verbal and written information, and contact numbers for ongoing support and counselling when they leave hospital.

'Interpreters should be used where appropriate. The opportunity to develop skills and knowledge through training and education should be made available for all staff who care for bereaved parents, and a robust support system should be in place for all who provide this type of specialist care.'


For more information

Sands stillbirth and neonatal death charity

RCNi

Emotional care for women who experience miscarriage

NICE

Guidance on Antenatal and postnatal mental health: clinical management and service guidance

The Lancet

Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis

The BMJ

Maternal and fetal risk factors for stillbirth: population based study
 

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