BRIEFING PAPER
Number 05595, 9 June 2016
Registration of stillbirth
By Catherine Fairbairn
Contents:
1. Registration of live births
2. Registration of stillbirth
3. The Government’s position
4. Private Member’s Bill
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Registration of stillbirth
Contents
Summary
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1.
Registration of live births
4
2.
2.1
2.2
2.3
Registration of stillbirth
Definition of “stillborn child”
Registration of stillbirth after 24 weeks of pregnancy
No registration of stillbirth before 24 weeks of pregnancy
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5
5
5
3.
The Government’s position
7
4.
Private Member’s Bill
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Cover page image copyright: Flower and hands – no copyright required / image cropped
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Commons Library Briefing, 9 June 2016
Summary
The birth of a baby who is born alive must be registered, whatever the length of the
completed pregnancy. The death of a baby born alive must be registered in the same
way as any other death.
When a baby is stillborn (born dead) after 24 weeks pregnancy, the birth must be
registered. However, there is no provision to allow the registration of stillbirths before the
24th week of pregnancy.
The charity Sands (Stillbirth and Neonatal Death charity) provides forms of certificate that
health care staff may use or adapt for a baby born dead before 24 weeks pregnancy.
In March 2016, the Government indicated that it has no plans to change the definition of
stillbirth which is based on the age of viability.
In January 2014, Tim Loughton introduced a Private Members’ Bill, intended to enable
registration of a child stillborn before the threshold of 24 weeks. The definition of
stillbirth was to be based on the experience of giving birth. The Bill did not progress any
further.
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Registration of stillbirth
1. Registration of live births
The birth of a baby who is born alive must be registered, whatever the
length of the completed pregnancy. If a baby lives for even a short
time after being born and then dies, both the birth and death must be
registered. 1 A neonatal death generally means a death within the first
28 days of life. This is distinguished from a stillbirth (where there are no
signs of independent existence).
1
Births and Deaths Registration Act 1953
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Commons Library Briefing, 9 June 2016
2. Registration of stillbirth
2.1 Definition of “stillborn child”
The definition of “stillborn child” in England and Wales is contained in
the Births and Deaths Registration Act 1953 section 41 as amended by
the Stillbirth (Definition) Act 1992 section 1(1) and is as follows:
“a child which has issued forth from its mother after the 24th
week of pregnancy and which did not at any time breathe or
show any other signs of life”.
Similar definitions apply in Scotland 2 and Northern Ireland. 3
2.2 Registration of stillbirth after 24 weeks of
pregnancy
When a baby is stillborn (born dead) after 24 weeks of pregnancy, the
birth must be registered. Information about how to register a stillbirth is
available on the following websites:
•
Gov.UK, Register a stillbirth (England and Wales); 4
•
National Records of Scotland, Registering a stillbirth (Scotland); 5
•
NIDirect, Registering a stillbirth (Northern Ireland). 6
2.3 No registration of stillbirth before 24 weeks
of pregnancy
There is no provision to allow the registration of stillbirths before the
24th week of pregnancy.
The charity Sands (Stillbirth and Neonatal Death charity) provides forms
of certificate that health care staff may use or adapt for a baby born
dead before 24 weeks pregnancy.
The Royal College of Obstetricians and Gynaecologists has published a
good practice note, Registration of stillbirths and certification for
pregnancy loss before 24 weeks of gestation. This includes a statement
on the interpretation and implementation of registration law where it is
known that a foetus has died in the womb before 24 weeks but is
expelled from the mother after 24 weeks:
…the legal advisors for the Department of Health and the Office
for National Statistics have agreed that a fetus that is expelled
after 24 weeks of pregnancy, provided it was no longer alive at
the 24th week of pregnancy (this fact being either known or
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3
4
5
6
Section 56(1) of the Registration of Births, Deaths and Marriages (Scotland) Act 1965,
as amended by the Stillbirth (Definition) Act 1992
Births and Deaths Registration (Northern Ireland) Order 1976, as amended by the
Stillbirth Definition Northern Ireland Order 1992
Gov.UK, Register a stillbirth, [accessed 9 June 2016]
National Records of Scotland, Registering a stillbirth [accessed 9 June 2016]
NIdirect, Registering a still-birth [accessed 9 June 2016]
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Registration of stillbirth
provable from the stage of development reached by the dead
fetus), does not fall within the category of births to be registered
as stillbirths under the above Acts. This interpretation is also
accepted by the General Register Office for Scotland and the
General Register Office for Northern Ireland. 7
The Practice Note also includes a number of questions and answers.
The Royal College of Midwives has also published a guidance paper on
the subject, Registration of stillbirths and certification for pregnancy loss
before 24 weeks’ gestation. 8
7
8
Royal College of Obstetricians and Gynaecologists, Registration of stillbirths and
certification for pregnancy loss before 24 weeks of gestation, Good Practice No 4,
January 2005
June 2005
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Commons Library Briefing, 9 June 2016
3. The Government’s position
In March 2016, junior Health Minister, Ben Gummer, indicated that the
Government has no plans to change the definition of stillbirth which is
based on the age of viability:
The Births and Deaths Registration Act 1953, as amended,
provides for the registration of babies born without signs of life
after 24 weeks’ gestation, which is the legal age of viability.
Parents of babies who are stillborn after 24 weeks’ gestation
receive a medical certificate certifying the stillbirth and, upon
registration, can register the baby's name and receive a certificate
of registration of stillbirth.
Parliament supported a change to the stillbirth definition from
“after 28 weeks” to “after 24 weeks” in 1992, following a clear
consensus from the medical profession at that time that the age
at which a foetus should be considered viable should be changed
from 28 to 24 weeks. Medical opinion does not currently support
reducing the age of viability below 24 weeks of gestation.
Therefore, there are no plans to amend the stillbirth definition.
Ben Gummer went on to acknowledge the distress this might cause to
some parents. He spoke of the certificate a hospital might issue, and
set out what the Government was doing to reduce the rates of
stillbirths, neonatal and maternal deaths, and brain injuries occurring
during or soon after birth:
We are aware that some parents find it very distressing that they
may not register the birth of a baby born before 24 weeks.
However, it is important to recognise there would also be parents
distressed at the possibility of having to do so. When a baby is
born without signs of life before 24 weeks’ gestation, hospitals
may issue a local certificate to commemorate the baby's birth.
In November 2015, the Government announced a national
ambition to halve by 2030 the rates of stillbirths, neonatal and
maternal deaths and brain injuries occurring during or soon after
birth. The announcement also committed to publishing an annual
report to update the public, health professionals, providers and
commissioners on the progress we are making towards achieving
the ambition.
To support the system in achieving this ambition we also
announced:
•
A £2.24 million capital fund for equipment to improve
safety.
•
Over £1 million to roll out training programmes to make
sure staff have the skills and confidence they need to
deliver world-leading safe care.
•
£500,000 to develop a new system that can be used
consistently across the National Health Service to enable
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Registration of stillbirth
staff to review and learn from every stillbirth and neonatal
death. 9
9
PQ 29604 [on Perinatal Mortality], 11 March 2016
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Commons Library Briefing, 9 June 2016
4. Private Member’s Bill
In January 2014, Tim Loughton (Conservative) introduced a Private
Members’ Bill, the Registration of Stillbirths Bill, 10 “to amend the Births
and Deaths Registration Act 1953 to provide that parents may register
the death of a child stillborn before the threshold of 24 weeks
gestation”. 11 He said that the definition of stillbirth would be based on
the experience of giving birth:
My Bill would provide for the official registration of stillborn
babies below 24 weeks’ gestation. It would not be based on a
crude time threshold of what is deemed a viable foetus, but on
the experience of giving birth.
The Bill did not proceed any further.
10
11
Bill 153 of 2014-14, introduced under the Ten Minute Rule, SO No 23
HC Deb 14 January 2014 cc726-8
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BRIEFING PAPER
Number 05595
9 June 2016
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