Expert Court Reports And Establishing The Cause Of A Stillbirth

The first week of July saw senior midwife Donna Ockenden formally close her investigation into failures at Shrewsbury and Telford NHS Trust (SaTH). The final report, which was released in April showed that at least 201 babies may be alive today had they received more competent care, including 131 who were stillborn.

Stillbirth is a devastating ordeal for a parent to go through and one that is still cloaked in silence. For a person to discover their baby has died and then to have to deliver the corpse through labour causes terrible pain and sadness. And because most people have no idea how to talk to a parent who has suffered a stillbirth, most are forced to deal with their pain alone.

Tragically, the cause of many stillbirths is unknown. However, a court report prepared by a midwifery expert witness can assist the court in cases where clinical negligence is alleged to have led to the foetus’s death. In this article, we discuss what stillbirth is and its possible causes.

What is a stillbirth?

A stillbirth is where a baby is born dead after 24 completed weeks of pregnancy. If a baby dies at less than 24 weeks it is referred to as a miscarriage.

One in 200 pregnancies ends in a stillbirth.

According to the World Health Organisation (WHO) over 40 percent of stillbirths occur during labour. In 2019, the UK stillbirth rate was three out of every 1000 births. By comparison, Spain was 2.2, Poland 2.3, and Austria 2.2.

baby loss

What causes stillbirth?

In many cases, the cause of stillbirth remains unknown, even after extensive testing. Where the cause can be identified, the below are the most common:

  • Pregnancy and labour complications such as placental abruption, pre-eclampsia, and preterm labour involving twins or triplets.
  • Problems with the placenta, for example, insufficient blood flow.
  • Genetic or structural birth defects.
  • Infections.
  • Umbilical cord problems.
  • Complications with the mother’s health.

Studies have also shown that women who experience financial, emotional, or other forms of stress during pregnancy are more likely to experience a stillbirth. The risk is also heightened for women who smoke and/or use illegal drugs.

Are stillbirth causes accurately reported?

A paper released in June 2022 identified that errors were present in three-fifths of medical certificates of stillbirths.

According to a study led by The University of Manchester and Edinburgh researchers – in collaboration with Manchester University NHS Foundation Trust (MFT) – in almost three-quarters of the stillbirths officially certified as being of “unknown cause of death,” there was in fact an identifiable reason for the baby’s passing. Foetal growth restriction and placental insufficiency were the main overlooked causes of stillbirth.

Can stillbirths be caused by medical negligence?

Stillbirths can result from clinical failures such as:

  • Not monitoring the baby’s heartbeat and other vital signs.
  • Missing signs of maternal infection.
  • Misinterpreting scans and test results.
  • Delaying a C-section when it is clear the mother cannot have a vaginal birth and/or the baby becomes distressed.
  • Failure to administer regular tests and check-ups.

Parents who are bringing a negligence claim involving a stillbirth are likely to be incredibly vulnerable and stressed. An experienced midwifery expert court report writer will act with the utmost sensitivity and compassion when asking questions and conducting examinations (if applicable). In such cases, the expert will have a strong desire to help grieving parents understand what caused their baby’s death.

Concluding comments

Medical negligence cases involving a stillbirth require clear, expertly analysed reports to ensure the court has the information it needs to make an informed decision. Our midwifery expert witness, Jayne Utting has over 23 years of experience both as a clinical midwife and senior manager. She is known for her compassion and empathy in difficult maternity cases and can quickly turn around accurate expert court reports. To find out more, please contact us on 01865 587865, email us at office@expertcourtreports.co.uk or alternatively, you can submit an enquiry via our online request form.

If you have been affected by this article, you can contact Sands, an organisation that supports anyone affected by the death of a baby. Sands’ free Helpline is available on 0808 164 3332 10am to 3pm Monday to Friday and 6-9pm Tuesday and Thursday evenings. You can also email helpline@sands.org.uk for support. www.sands.org.uk/support