Stillbirth vs. Miscarriage: How They’re Similar and How They’re Different

A stillbirth occurs when a baby dies after 20 weeks of pregnancy. The baby may die in the uterus, or it may be born dead.

According to the Centers for Disease Control and Prevention (CDC), stillbirth affects 1 in 160 births in the United States. About 24,000 babies are stillborn in the United States each year.

Stillbirths can be further classified into three groups:

• Early stillbirth: This is the fetal death in the late second trimester, between 20 and 27 weeks.
• Late stillbirth: This is the fetal death in the third trimester, between 28 and 36 weeks.
• Term stillbirth: This is the fetal death at full term, between 37 or more weeks.

A stillborn baby won’t have any signs of life. They will stop breathing, and they have no heartbeat.

A miscarriage occurs when a baby dies in the womb or uterus before 20 weeks of pregnancy. A miscarriage may happen before a person even knows they’re pregnant.

A miscarriage, also called early pregnancy loss or spontaneous abortion, is more common than a stillbirth. The March of Dimes says 10% to 15% of all pregnancies in the United States end in a miscarriage. The number may actually be higher, as many are never reported.

Most miscarriages happen in the first trimester (before 12 weeks). The American College of Obstetricians and Gynecologists (ACOG) says 80% of all pregnancy loss occurs in the first trimester.

Miscarriages in the second trimester (or 13 to 19 weeks) are less common.

Stillbirth and miscarriage are both forms of pregnancy loss. They occur at different periods in a person’s pregnancy.

These terms are also often used interchangeably. However, there are some distinct differences. These include:

• Time: A stillbirth describes pregnancy loss in the second half of pregnancy. A miscarriage describes pregnancy loss before week 20.
• Signs and symptoms: Both stillbirth and miscarriage can cause abdominal cramping, spotting, or bleeding, but a stillbirth is more likely to cause fluid leakage from the vagina before bleeding starts. Some people also experience a gush of fluid leaving the vagina. The fluid leaks or gushes because of a rupture of membranes that surround the baby in the uterus. This is unlikely to occur with a miscarriage.

• Treatment: People who experience a stillbirth may have a labor induction. This procedure advances labor so that you can deliver the baby vaginally. People experiencing a miscarriage may be given medication to help the body eliminate the tissue. A dilation and curettage (D&C) may be necessary to remove any remaining tissue from the uterus. If the pregnancy is in the third trimester or near term, a dilation and evacuation of the fetus (D&E) may be necessary. A natural miscarriage won’t need additional treatment.

Stillbirth and miscarriage are often used as one term, and it’s easy to see why: They do have several common factors. These include:

• Signs and symptoms: A stillbirth may lead to fluid leaking from the vagina, but most people experience spotting, bleeding, and abdominal cramping, no matter when the pregnancy loss occurs.
• Result: Both terms describe the loss of a pregnancy. No matter when it happens, this can be devastating.
• Diagnosis: To confirm a pregnancy has been lost, a doctor will conduct an ultrasound to verify the fetus or baby no longer has a heartbeat.

In many cases, the cause of stillbirth is never known. But, according to ACOG, the most common factors for stillbirth include:

• Genetic abnormalities: According to ACOG, irregular chromosomes cause 6% to 13% of all stillbirths.
• Advanced maternal age: People over 35 years are more likely to experience pregnancy loss.
• Physical problems: Issues with the uterus, placenta, or cervix can lead to pregnancy loss. These issues might include fibroids, infections (such as sexually transmitted infections), and placental abruption.
• Illness: Food poisoning, such as listeriosis, can lead to pregnancy loss.
• Maternal health: Common health issues, including high blood pressure, diabetes, and obesity, increase the risk for stillbirth.
• Umbilical cord problems: Issues with the umbilical cord account for 10% of all stillbirths. These include cutting off oxygen to the baby and cord entrapment, or when the umbilical cord becomes wrapped around the baby’s neck or head.

The causes of a miscarriage, like stillbirth causes, are sometimes not known. When they are, they commonly fall into one of these:

• Chromosomal abnormalities: The majority of miscarriages are the result of a problem with the fetus’s chromosomes. If you want, tissue from the miscarriage can be tested to confirm if there were issues with the chromosomes.
• Birth irregularities: Fetal abnormalities are another common cause of miscarriage.
• Maternal age: People over 35 years are more likely to experience pregnancy loss.
• Prior early pregnancy loss: It’s possible to have successful pregnancies after a miscarriage, but people who have had one or more miscarriages may be more likely to have another in the future.
• Placental irregularities: A healthy placenta is necessary for a full-term pregnancy. If it’s not formed properly, the pregnancy can’t survive.

The causes for a miscarriage can also cause stillbirth. But certain issues are more common in early pregnancy loss versus later losses.

A stillbirth may be detected before labor even begins. During routine check-ups, your OB-GYN or doctor may not be able to hear a heartbeat. Your doctor may also measure things like your amniotic fluid level, fetal movement, and breathing.

Additionally, you may notice the baby has stopped moving.

An ultrasound can confirm if the baby has died.

During labor, a fetal monitor checks the baby’s heart rate. It will alert care providers to issues during this time. If they detect any changes to the heart rate, different delivery options may be needed to deliver the baby quickly.

As with a stillbirth, sometimes a miscarriage isn’t found until a checkup. This is especially true in early pregnancy when fetal movement isn’t easily felt.

If a doctor doesn’t find a heartbeat during an ultrasound, you have miscarried.

Very early in pregnancy, a vaginal ultrasound may be needed to confirm if a fetus is lost or not.

Most stillbirths are unavoidable. They are the result of physical issues during the pregnancy or irregularities with the baby.

However, a few good practices may reduce the risk of stillbirth. These include:

• If you smoke, consider quitting.
• Avoid alcohol and drugs.
• Properly treat any underlying health issues, such as high blood pressure and diabetes.
• Attend regular prenatal visits.
• Limit caffeine and stimulants.
• Sleep on your side, not your back.

Miscarriages are also often the result of factors outside your control. Early pregnancy loss is almost always the result of abnormalities in the fetus or placenta. There’s little a pregnant person can do to avoid those.

However, a few good measures can be taken to reduce the risk of a miscarriage:

• Take folic acid, as this can help prevent birth defects that could lead to pregnancy loss.
• If you smoke, consider quitting.
• If you drink, consider quitting alcohol.
• Avoid drugs.
• Treat underlying health issues.

Despite their differences, the risk factors for both stillbirth and miscarriage are similar. These include:

• Age: People over the age of 35 are more likely to experience pregnancy loss.
• Race: Black people have a higher risk of miscarriage or stillbirth. It’s important to note that the stress of enduring racism, discrimination, and racist systems may play a part in this.
• History of substance use: People who smoke cigarettes are more likely to have a pregnancy loss.
• Exposure: Being around chemicals, even secondhand smoke, can put you at a higher risk for pregnancy loss.
• Health conditions: Obesity, high blood pressure, and diabetes can cause pregnancy loss.
• Previous pregnancy loss: Many people who lose a pregnancy will be able to have successful ones in the future, but having lost one or more pregnancies already can increase your risk.

Pregnancy loss, no matter the timeframe, is difficult. Grieving this loss takes time. Your body also needs time to heal.

Most people will need a few weeks after a miscarriage or stillbirth to recover physically. The time may be extended if you went through labor and delivery to birth the baby.

The emotional impact may last longer. It’s important to seek support from a partner, friends, and family after a loss like this. Grief can feel overwhelming, but the support of others can help.

You may have other questions about the similarities and differences between a miscarriage and a stillbirth. These might help:

What’s a missed abortion (or miscarriage)?

A missed abortion or missed miscarriage is a miscarriage that’s discovered during an ultrasound. Some early pregnancy losses don’t cause symptoms. That may make them difficult to detect. This pregnancy loss may first be found during a routine ultrasound at a prenatal visit.

What are repeat miscarriages?

People who have one miscarriage are more likely to have another. According to the March of Dimes, about 1% of pregnancies are repeat miscarriages. These recurrent pregnancy losses are called repeat miscarriages.

If you’ve had multiple miscarriages, you’ll likely have a workup for something called antiphospholipid syndrome, an autoimmune condition that affects blood cells.

Many people who have repeat or multiple miscarriages are able to have a successful pregnancy later.

When can you try to get pregnant again?

This answer will be different for each person because that answer depends on you. This personal decision should take into account your physical health, your emotional health, and your previous pregnancy experiences.

However, physically, most people can try to get pregnant again after their first regular period.

Stillbirth and miscarriage are two terms that describe the same event: pregnancy loss. That’s why they are frequently used interchangeably. However, they do describe two different types of loss.

A miscarriage happens in the first half of pregnancy, within the first 20 weeks.

A stillbirth happens in the second half, between weeks 21 and full term.

They have several other similarities, including symptoms and the way they’re diagnosed. But they are different in other ways, too. Specifically, they’re often treated differently.