Losing a child at any age is devastating and traumatic. However, it can be particularly distressing and shocking when you lose a child during your pregnancy or shortly after birth. Often the terminology used, or the information provided, can be difficult to understand and comprehend in what are extremely difficult times.
Much of the terms used depend on the medical and legal definition and can often feel clinical, cold, or inconsiderate. However, here we will try and set out some information that may provide some guidance and insight.
What is it? A definition
The definition of a neonatal death refers to a baby who has died in the first 28 days of life. Unlike a stillbirth, this definition covers a liveborn child – a child born at any gestation showing signs of life at delivery.
The terminology at the point of birth changes, in that your child is no longer referred to as a foetus in the mother’s womb and becomes its own individual person. For this reason, any liveborn child who subsequently dies, at whatever point in their life, must be registered by law. A registration of birth and death is required.
Causes – common examples
Despite significant and extensive research into neonatal deaths, the risk can never be eradicated completely. However, there are occasions when lack of treatment, or substandard treatment, contributes to a neonatal death. The possible causes and factors in neonatal deaths are varied and vast and can mirror issues that contribute to stillbirth cases.
The most common causes for neonatal death are:
- Premature birth – a baby born before 37 weeks gestation is more likely to experience life-threatening complications
- Complications during birth (link to other sections) – such as lack of oxygen
- Birth defects – internal or external defects affecting the baby’s health, development and growth
- Low birth weight – any baby weighing less than 2.5g is high risk
- Genetic conditions
- Infections acquired in the womb before birth- such as Hepatitis B, Group Strep B
- Infections acquired after birth – from external sources such as sepsis
- Problems developed during pregnancy – such as issues with the placenta and umbilical cord, preeclampsia
- hypocalcaemia and issues related to food and nutrition
Whilst some of these causes cannot be avoided entirely there are examples when negligent care provided during the pregnancy or birth contribute to these risks. A lot of these conditions can be diagnosed and treated with prompt action from the medical staff. Negligence can occur when these symptoms are missed, ignored, or diagnosed too late.
What is clear is that with earlier diagnosis and treatment, the better the chance of survival for your baby. Treatment needs to be acute and immediate. Ideally, treatment should be provided in a dedicated neonatal treatment centre with appropriate equipment and specialist medical staff. In cases where there is no specialist neonatal unit, specialist input can be obtained from these centres remotely and on occasions it may be appropriate and safe to transfer your child. In cases where this is not possible, either due to the child’s or mothers’ ill health, specialist care will still be provided by the hospitals dedicated paediatric and intensive care team.
The charities and organisations listed below can help with emotional and practical support for parents, siblings and grandparents.
Some cases, if the cause of death is uncertain or unclear a post-mortem may be required to determine the cause of death. In some circumstances the case may be referred to the local coroner for further investigation. We also have more information about Inquests here.