There’s a wide range of reasons why babies die. We look at causes of stillbirths (death before birth) and deaths of newborn babies separately as different problems are more common in each group.
Many people think that stillbirths happen because of a developmental or genetic problem that means the baby could not survive. In fact, this is the case for fewer than one in ten stillborn babies. For as many as four in ten stillborn babies, the cause of death is not known.
The placenta is the organ that joins the baby and mother in the womb, allowing nutrients and oxygen to pass to the baby. Some stillbirths happen because the placenta doesn’t function properly. This may happen gradually, and it may not be picked up by current routine antenatal monitoring.
A baby who doesn’t get the right balance of nutrients may grow more slowly than expected. So a tailing off of a baby’s growth during pregnancy can signal a problem. Babies who are becoming poorly may move less often, too.
Sands helped fund research (the AFFIRM study) that asked whether encouraging women to be aware of their baby’s movements and to tell their midwife promptly if their baby’s movements have changed could help reduce the number of stillbirths. If you are pregnant and have any concerns about your baby’s movements, please contact your maternity unit straight away.
We have also funded research looking at scanning in third trimester, which is aimed at improving methods for identifying babies who are not growing as they should.
Other causes of stillbirth include:
- bleeding (haemorrhage) before or during labour,
- placental abruption, when the placenta separates from the womb before the baby is born,
- complications of pre-eclampsia, which is linked with the placenta and causes high blood pressure,
- the umbilical cord slipping down through the entrance of the womb before the baby is born (known as cord prolapse) or wrapping around the baby’s neck,
- a liver disorder called intrahepatic cholestasis of pregnancy (ICP),
- genetic conditions,
- infection (go to NHS Choices for more information).
Incidents during birth
Around 100 babies die every year because of a trauma or event during birth that was not anticipated or well managed. Some babies are stillborn and some die after birth. Many of these deaths, when they occur at term, could be avoided with better care. Recently, with improving NHS care, the number of these deaths is falling.
Neonatal deaths can be linked with:
- prematurity or low birthweight, both of which increase the likelihood of serious health problems
- genetic disorders
How many babies die?
Sadly, the death of a baby is not a rare event: around 13 babies die before, during or soon after birth every day in the UK.
In the UK in 2020, around 1 in every 260 births was a stillbirth. In total there were 2,638 stillbirths. That’s around eight babies stillborn every day.
Around one-third of stillbirths happen after 37 weeks of pregnancy.
Stillbirths account for more than half of the deaths of infants under one year in the UK.
Stillbirth rates remained largely unchanged from the late 1990s to 2011. From 2012 the rate started to fall. But more deaths could be prevented.
In the UK in 2020, 1,895 babies died within the four week of life. That’s one baby in every 360 births.
The number of babies who die in the neonatal period (the first 28 days after birth) has dropped over the last decade, largely because of advances in medical knowledge and clinical care. But recently the mortality rate has plateaued.
A stillborn baby is one who has died before or during birth, at or after 24 weeks of pregnancy.
A neonatal death happens in the first 28 days after birth.
Stillbirths and baby deaths that happen in the first seven days of life, are sometimes counted together and called perinatal deaths.
Office for National Statistics, Vital statistics population and health reference tables, Dec 2021
Why are the figures Sands uses for baby deaths from 2020, and not more recent?
There are two main sources of figures for baby deaths for the whole UK. For both, the process to make sure the data is complete and accurate is complex and takes time. This leads to a lag between the end of the year and the release of the figures for that year.
The figures for baby deaths need to be compared with the numbers of live births to understand the rate of deaths, not just the total number of deaths. This ‘validation’ of the figures adds to the time it takes to prepare the data.
The most recent data available for the UK is for 2020. Figures for UK baby deaths in 2021 will be published in late 2022.
We need timely statistics. Can anything be done to speed this up?
Sands has fed back the importance of timely data to both bodies who produce national data . They have listened to the feedback and both are working hard to further minimise the lag.
Who collects the data?
There are two main sources of statistics for baby deaths:
- Deaths notified to the national register for births and deaths, and the stillbirth register (this is when parents register their baby’s birth and death, or stillbirth). This data is collected in each UK country and collated by the Office for National Statistics (ONS)
- Deaths notified by the hospital to the national audit programme which collects data for the whole UK on baby deaths from 22 weeks gestation to 4 weeks of life – the programme is run by MBRRACE-UK
When are the figures published?
The registration data has less detail than the hospital data and is published sooner.
For deaths in a calendar year:
- ONS publishes figures at the end of the following year
- MBRRACE-UK publishes data in the autumn of the second year
What is the difference between ONS and MBRRACE-UK data?
ONS collates registration data from each of the four UK countries. This includes basic information about the baby (such as gender and date of birth/death/stillbirth) and the parent/s (such as names and age), and a cause of death.
The most recent ONS UK data set is for 2020.
We use ONS figures to monitor trends in mortality, year on year, and to hold governments to a account for progress against targets to cut rates of baby deaths
When a baby dies between 22 weeks gestation and 4 weeks of life, the hospital staff complete an MBRRACE-UK notification form which includes more detail about the baby and mother’s health, the care, and cause of death.
MBRRACE-UK publishes the data in an annual report (called the perinatal surveillance report). It includes a summary infographic and Trust/Health Board-level outcomes.
The most recent data and report, published in October 2021, looked at deaths in 2019.
We use MBRRACE-UK data to understand more about factors affecting baby deaths, for example the impact of ethnicity and social deprivation. We can look at trends in outcomes at Trust/Health Board level. The data helps identify where we should be focusing our energies in preventing deaths
What about statistics for each country in the UK?
MBRRACE-UK collects hospital data on baby deaths on behalf of all 4 UK countries, and reports for the UK in the annual reports.
Registration data is gathered separately in each UK country. The countries publish their own data on slightly different timetables. ONS then pulls the figures together for the whole UK.
National Records for Scotland report annual stillbirth and neonatal deaths during the following year. The latest figures are for 2020.
For Northern Ireland
The Northern Ireland Statistics Research Agency collects the registration data. It’s published annually in the Register General’s report, in the following year
Registration data for Wales is reported by ONS, alongside figures for England (see below).
ONS publish stillbirth figures for England and Wales in the following year. During the pandemic, ONS has reported provisional stillbirth figures sooner than the confirmed figures, to help understand the impact of COVID 19 in pregnancy
ONS reports neonatal deaths for England and Wales lightly later than stillbirths. This is because it takes longer to ensure the deaths data is complete.
There are different datasets available on the ONS website, reporting different aspects.
How does Sands use statistics about baby deaths?
We work to hold UK governments to account on their and our targets to cut baby deaths, and push for changes that will make maternity and neonatal care safer.
We work strategically with national bodies, for example the Maternity Consortium, and parliamentary groups such as the Health Select Committee and the All Party Parliamentary Group on Baby Loss, raising the issue of safety and inequalities in outcomes.
Sands action has led to a confidential enquiry into Asian baby deaths, to run along an MBRRACE-UK enquiry into Black baby deaths. To enhance the enquiries with the perspective of Black and Asian parents’ experiences, we will be canvassing bereaved families to hear and share their views.