Miscarriage and stillbirth

The loss of a baby during pregnancy is just as devastating no matter what it is termed, but technically a miscarriage describes the loss of a baby before 20 weeks of pregnancy and stillbirth describes the loss of a baby after 20 weeks.

A miscarriage occurs when the foetus is expelled from the uterus before it has developed enough to survive. This usually happens when the foetus isn’t developing properly, which causes pregnancy hormone levels to drop and results in the pregnancy disconnecting from the uterus and being expelled.

A stillbirth occurs when the foetus is dead at birth and requires registration of both its birth and death.

Causes of miscarriage

The majority of miscarriages occur during the first trimester and are usually due to foetal abnormalities that result in the pregnancy being unsustainable.

Miscarriage in the second trimester are usually due to:

  • Incompetent cervix – when the cervix begins to thin and dilate long before your due date
  • Placental problems – most common of these are insufficiency, where the placenta is not providing the necessary nutrients and oxygen to the foetus

Causes of stillbirth

Because of pregnancy health and the level of antenatal care now available, it is very uncommon for a baby to die in late pregnancy. Sometimes, though, it does happen – often without warning. Causes can include:

  • Infection
  • Placental problems such as placenta praevia
  • Foetal abnormality

Sometimes, even after an autopsy, it isn’t possible to determine a cause of death which can be extremely distressing for the parents. Approximately 30% of stillbirths can’t be explained.

Symptoms of miscarriage and stillbirth

  • Spotting or bleeding from your vagina
  • Mild to severe abdominal cramps
  • Dizziness
  • High fever
  • No foetal movements
  • No heartbeat can be detected

Treatment of miscarriage and stillbirth

  • If an incompetent cervix is threatening a miscarriage you can have a procedure where a stitch is placed in the cervix to prevent it from further dilation.
  • If you are suffering a miscarriage, particularly if it is in early pregnancy, you may not need to take any action as it is likely that your body will deal with the process naturally.
  • If you body doesn’t fully expel the contents of your uterus, you may need to have a surgical procedure called Dilation and Curettage (D&C), that manually removes the remains of your pregnancy.
  • A baby who has died in utero must still be born and so you will need to decided how you want to proceed – caesarean deliveries are not usually recommended, and as most stillbirth labours need to be induced, many women opt for a vaginal birth using pain relief.
  • Once the physical aspects of losing your baby have been dealt with, it is important to find support and comfort in loved ones at the set aside time to grieve properly. Miscarriage and stillbirth mean the loss of a baby, no matter how young, and this will cause grief for the parents.


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