Pregnancy loss is a deeply emotional and complex experience for many families, and understanding the terminology used to describe different types of pregnancy loss can be confusing. Among the terms that often cause uncertainty are stillbirth” and “miscarriage.” Many wonder if a stillborn baby is considered a miscarriage or if these terms represent distinct events. Clarifying the differences between stillbirth and miscarriage, their causes, timing, and medical definitions can help provide better understanding and support for those affected by pregnancy loss.
Defining Miscarriage and Stillbirth
Miscarriage and stillbirth both refer to the loss of a pregnancy, but they differ primarily in terms of timing and medical criteria.
What Is a Miscarriage?
A miscarriage is defined as the spontaneous loss of a pregnancy before the fetus reaches viability, typically before 20 weeks of gestation. It is the most common type of pregnancy loss and occurs in approximately 10-20% of known pregnancies. Miscarriages usually happen early in pregnancy, often during the first trimester, but can occur up to 20 weeks.
What Is a Stillbirth?
Stillbirth is the loss of a baby after 20 weeks of pregnancy, or when the fetus reaches a weight of at least 350 grams, depending on regional definitions. This term is used when a fetus dies in the womb but is delivered after this point in gestation. Stillbirth affects about 1 in 160 pregnancies in developed countries, and it is a devastating event that typically occurs in the second or third trimester.
Is a Stillborn Considered a Miscarriage?
Medically and legally, a stillborn baby is not considered a miscarriage due to the differences in timing and viability. The cutoff point at 20 weeks gestation is significant because before this, a fetus is generally not viable outside the womb. After 20 weeks, the fetus has a chance, though sometimes small, of survival if born prematurely. Therefore, pregnancy losses before 20 weeks are classified as miscarriages, while losses after 20 weeks are termed stillbirths.
Why the Distinction Matters
- Medical ManagementThe care and procedures involved in managing a miscarriage differ from those for a stillbirth. Stillbirth often requires labor induction, while miscarriages might be managed expectantly or with medication.
- Emotional and Legal RecognitionStillbirth often leads to a different kind of mourning and legal documentation, including death certificates and eligibility for burial or memorial services, which are not typically provided for miscarriages.
- Support and CounselingFamilies may receive different types of counseling and support depending on whether the loss is a miscarriage or stillbirth.
Causes and Risk Factors
Both miscarriages and stillbirths share some common causes but can also differ depending on the stage of pregnancy.
Common Causes of Miscarriage
- Chromosomal abnormalities in the fetus
- Hormonal imbalances
- Infections
- Uterine abnormalities
- Maternal health conditions such as diabetes or thyroid disease
- Lifestyle factors like smoking, alcohol, and drug use
Common Causes of Stillbirth
- Placental problems affecting oxygen and nutrient delivery
- Umbilical cord complications
- Infections in the mother or fetus
- Chronic maternal conditions such as high blood pressure or diabetes
- Fetal growth restriction
- Complications during labor
Signs and Symptoms
Recognizing the signs of pregnancy loss is crucial for timely medical care and emotional support.
Signs of Miscarriage
- Vaginal bleeding or spotting
- Cramping or abdominal pain
- Passing tissue or fluid from the vagina
- Decrease in pregnancy symptoms such as nausea or breast tenderness
Signs of Stillbirth
- Absence of fetal movements after 20 weeks
- Vaginal bleeding or fluid leakage
- Cramping or abdominal pain
- Confirmed absence of heartbeat on ultrasound
Diagnosis and Medical Procedures
Both miscarriage and stillbirth require medical confirmation and management to ensure the health and safety of the mother.
Diagnosing Miscarriage
Diagnosis usually involves pelvic ultrasound to check for fetal heartbeat and growth, along with blood tests to measure pregnancy hormone levels. In some cases, expectant management or medical treatment may be used to allow the body to pass the pregnancy tissue.
Diagnosing Stillbirth
Stillbirth is confirmed through ultrasound demonstrating no fetal heartbeat after 20 weeks. Additional tests may be done to determine the cause, such as blood tests, placental examination, and genetic studies. Labor induction is typically necessary to deliver the stillborn baby.
Emotional Impact and Support
Both miscarriage and stillbirth can have profound emotional effects on parents and families. The grief can be intense and long-lasting, and it is important to seek compassionate care and support.
Coping with Miscarriage
- Understanding that miscarriage is common and often not the mother’s fault
- Seeking counseling or support groups
- Allowing time for physical and emotional healing
Coping with Stillbirth
- Grieving the loss of a baby who lived into later pregnancy
- Having opportunities for memory-making, such as photos and ceremonies
- Accessing specialized bereavement counseling and support networks
While both miscarriage and stillbirth represent heartbreaking pregnancy losses, they are medically distinct based on gestational age and viability. A stillborn baby is not considered a miscarriage because the loss occurs after 20 weeks of gestation, marking a different stage of pregnancy and requiring different medical and emotional care. Understanding these differences can help families navigate their experiences with greater clarity and access appropriate support. If you or someone you know is coping with pregnancy loss, it is important to reach out to healthcare professionals and support organizations to ensure both physical recovery and emotional healing.