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Stillbirth rates are falling in England and Wales

An overview of stillbirth numbers and rates in England and Wales and a European comparison.

What is the legal definition of a stillbirth?

Registrations for stillbirths began on 1 July 1927 in England and Wales when the annual estimated number of stillbirths was calculated as 26,021 (14,519 males and 11,502 females). The numbers steadily decreased during the 20th century and in 2013 the number stood at 3,284. The ratio of male stillbirths to female stillbirths was 1.1 in 2013, that is there were more male stillbirths compared to female stillbirths.

The Births and Deaths Registration Act 1953, as amended by the Stillbirth Definition Act 1992, provides for the registration of all babies born after 24 or more weeks completed gestation that did not, at any time, breathe or show signs of life, as stillbirths in England and Wales. Similar definitions apply in Scotland and Northern Ireland. There are no provisions to allow the registration of stillbirths before the 24th week of pregnancy.  Prior to 1992, only babies born showing no sign of life after the 28th week of gestation were counted as having been stillborn. Therefore, the figures for stillbirths from 1993 are not fully comparable with those for previous years.

The causes of many stillbirths remain unknown, but may include maternal infections in pregnancy, maternal disorders (especially hypertension and diabetes) or congenital abnormalities.

How has the stillbirth rate in England and Wales changed since 1927?

As shown in Figure 1, most of the reduction in stillbirth rates in England and Wales occurred during the 20th century, the rate falling from 38.3 stillbirths per 1,000 live births and stillbirths in 1927 to 4.3 stillbirths per 1,000 live births and stillbirths in 1992, when there was a definition change. Since then, the stillbirth rate has fallen by almost 18%, from 5.7 stillbirths per 1,000 live births and stillbirths in 1993 to 4.7 stillbirths per 1,000 live births and stillbirths in 2013.

Figure 1: Stillbirths (numbers and rates), 1927 to 2013

England and Wales

Figure 1: Stillbirths (numbers and rates), 1927 to 2013
Source: Office for National Statistics

Notes:

  1. Stillbirth rates at or after 24 weeks of gestation.
  2. Following the definition change in 1992, figures for stillbirths from 1993 are not fully comparable with those for previous years.
  3. Registration of stillbirths commenced on 1 July 1927. Equivalent annual figures for 1927 are estimated.
  4. Figures relate to the number of births registered in each year up to 1937 inclusive and thereafter to the number occurring each year.

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How do stillbirth rates vary across England and Wales?

The stillbirth rate in England in 2013 was 4.6 stillbirths per 1,000 live births and stillbirths and the rate for Wales was 4.5 stillbirths per 1,000 live births and stillbirths. The stillbirth rate varied across England, with the lowest stillbirth rate in the South West at 3.6 and highest in London at 5.3 stillbirths per 1,000 live births and stillbirths.

Table 1: Live births and stillbirths, and area of usual residence, 2013

England and Wales

Area of usual residence of mother Live births Stillbirths Stillbirths per 1,000 live births and stillbirths
England and Wales and elsewhere¹ 698,512 3,284 4.7
England 664,517 3,103 4.6
Wales 33,747 153 4.5
North East                      28,961 146 5.0
North West                      86,372 432 5.0
Yorkshire and The Humber     64,560 334 5.1
East Midlands                   52,895 224 4.2
West Midlands                   71,188 347 4.9
East                            71,309 285 4.0
London                          128,332 685 5.3
South East                      102,190 437 4.3
South West                      58,710 213 3.6
Usual residence outside England and Wales 248 28 101.4

Table source: Office for National Statistics

Table notes:

  1.  Includes births to women whose usual residence is outside England and Wales.

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How do stillbirth rates vary across Europe?

Across the world, definitions of what constitutes a stillbirth vary country by country, often according to weight and gestational age of the baby and this makes it difficult to explain any differences between countries. The World Health Organisation (WHO) recommended definition for international comparison is a baby born with no signs of life at or after 28 weeks gestation. It should be noted that this is different to the definition stipulated by the Stillbirth Definition Act 1992.

To account for the differences in legislation, regulations and practices for registering births and deaths across Europe and to make the rates more comparable across countries, a 2010 EURO-PERISTAT project standardised the data on stillbirths that was collected and presented mortality rates per 1,000 total births at or after 28 weeks. This gestation length was chosen because their analyses illustrated that this definition provided more comparable data and therefore more useful comparisons. We should also consider the different practices for induced abortions for congenital abnormalities of each country when interpreting the results from the different countries. 

In 2010, using the standardised definition (at or after 28 weeks gestation), stillbirth rates ranged from 1.5 stillbirths per 1,000 live births and stillbirths in the Czech Republic to 4.3 in France. The rate for England and Wales was 3.8 stillbirths per 1,000 live births and stillbirths, compared to 5.1 using the Stillborn Definition Act 1992 definition (at or after 24 weeks gestation).

Figure 2: A European comparison of stillbirth rates in 2010

Figure 2: A European comparison of stillbirth rates in 2010
Source: Eurostat

Notes:

  1. Stillbirth rates at or after 28 weeks of gestation.

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Would you like to see more on stillbirth and birth statistics?

There’s more information about stillbirths in Characteristics of Birth1, England and Wales, and Characteristics of Mother1, England and Wales.

More information about birth statistics can be found in the Birth Summary Tables and Vital Statistics: Population and Health Reference Tables. For data for other UK countries there’s the latest birth statistics for Northern Ireland and the latest birth statistics for Scotland.

There’s more information on data quality, legislation and procedures relating to birth statistics, in Births Metadata (332.6 Kb Pdf) and Quality and Methodology Information (218.6 Kb Pdf) for birth statistics.

Further information about the Health and Care of Pregnant Women and Babies in Europe in 2010 can be found in the European Perinatal Health Report.

Information about causes of stillbirth can be found at Causes of Stillbirth on the NHS choices webpage.

If you have any comments or suggestions, please email us at: vsob@ons.gsi.gov.uk.

Categories: Population, Births and Fertility, Live Births and Stillbirths, Live Births, Stillbirths, Maternities
Content from the Office for National Statistics.
© Crown Copyright applies unless otherwise stated.