The complexity of miscarriage and stillbirth terminology

In October 2023, Team GB’s Rebecca Adlington shared the devastating news that her daughter, Harper, died at 20 weeks.

We're heartbroken for Rebecca and her family, but also grateful she shared her experience, helping to break the silence around baby loss.  

Different definitions for loss

When reporting on this, we saw media outlets referred to Rebecca's loss differently - with some saying she had a miscarriage, and others a stillbirth. Often, this can be because the definitions between miscarriage, second trimester loss and stillbirth aren't commonly known. This continues to show more needs to be done to raise awareness of baby loss - and why here at Tommy's, we're committed to doing so.  

We know seeing this variation in reporting can be confusing for those who haven’t experienced baby loss, and potentially upsetting for those who have.  

With this in mind, we thought it would be helpful to share more information on what these different terms - miscarriage, second-trimester loss and stillbirth - mean.  

But its important to remember, no matter when or how you lost your baby, your loss matters and is personal to you. So, however you choose to refer to your loss is completely your choice.

What is a miscarriage?

In the UK, the loss of a baby before 24 weeks of pregnancy is referred to as a miscarriage. An estimated 1 in 5 women experience miscarriage, but sadly we know this number could be much higher as the Government isn’t formally counting.

Most miscarriages happen in the first 12 weeks, which is known as early miscarriage. The most common cause is chromosomal abnormalities (problems in development) and sadly cannot be prevented, but we hope to change this with more research. 

What is a second trimester loss?  

Second trimester loss, sometimes called a late miscarriage or mid-trimester loss, refers to losing a baby between 14 and 23+6 weeks of pregnancy. A loss at this stage isn’t very common – only happening in around 1-2% of all pregnancies, but we’re not sure as the UK doesn’t current collect official miscarriage data.

We know many who have had a loss at this stage who will have given birth to, and held, their baby. Understandably, these parents don't feel the term 'miscarriage' represents their experience.

It can be very hard to understand why a late loss is called a miscarriage rather than a stillbirth. This is because it is a legal definition, rather than a purely medical term. We know this can be difficult and feel arbitrary or unfair, that the loss of a baby before or during birth before 23 weeks is treated differently to one after 24 weeks.

Support after second trimester loss

Right now, we know the care and support available to someone who has lost their baby between 14-23 weeks varies across the UK. After 23 weeks, special care pathways exist and after 24 weeks, which is the legal definition of stillbirth, there are broader legal entitlements like bereavement leave and income-related benefits.

We’re currently working on new research to better care for people who are at risk of losing a baby between 14-23 weeks, and once our research is published, we’ll be launching a new campaign.

Our research into preventing baby loss

It’s sadly not always possible to find a reason why a baby died in pregnancy. This can be particularly hard to hear when you’re grieving your baby and want to understand what happened, and why your baby died.

But, it’s important to remember that your loss is very unlikely to be caused by anything you did or didn’t do.

That’s why our team at Tommy’s Maternal and Fetal Health Research Centre are focused on learning more about the main causes of second trimester baby loss and stillbirth and how it can be prevented. Since 2010, the centre has reduced the stillbirth rate in the Greater Manchester area by 32% through the specialist care it delivers.

In 2013, the Rainbow Clinic was opened at St Mary’s Hospital in Manchester. Here, women and birthing people who have had late baby loss or stillbirths are given the best possible care, to help and support them through their following pregnancies. We’ve also helped to roll out the Rainbow Clinic model to 28 other clinics across the UK.

Finding support and advice

We know this topic can be particularly difficult, and every loss is deeply personal for each person. However you describe your baby and your loss is completely up to you.

Wherever you are on your pregnancy journey, however you're feeling, we're here for you. Our support resources are available online whenever you need them.