House of Commons Library

The investigation of stillbirth

Published Thursday, November 30, 2017

This Commons Library briefing paper deals with the way stillbirth is investigated at present and the Government announcement about independent investigations in fuure

Jump to full report >>

This briefing paper deals with the position in England and Wales.

Current investigation of stillbirth in England and Wales

All unexpected or avoidable deaths, including those of mothers or babies, which may have been the result of healthcare failings should currently be investigated as serious incidents, under NHS England and NHS Wales national frameworks.

The Department of Health and the Welsh and Scottish Governments have also jointly commissioned a standard Perinatal Mortality Review Tool, to assist maternity and neonatal units in investigating all stillbirths and perinatal deaths. A pilot was launched in summer 2017, with full rollout planned for the end of the year.

Coroners and stillbirth

At present coroners do not have power to investigate a stillbirth. There has to have been an independent life before the coroner has jurisdiction to investigate a subsequent death.  The definition of stillbirth is based on there not having been an independent life, meaning that the coroner does not have jurisdiction to investigate. 

There have been a number of calls for the law to be changed, including by Sands, the stillbirth and neonatal death charity, and in Parliamentary debate. A Private Member’s Bill, introduced by Tim Loughton (Conservative), would “give coroners the power to investigate stillborn deaths”. The Bill is due to have its second reading on 2 February 2018. 

In Northern Ireland, which has its own legislation, the position is now different. In 2013, in a landmark decision, the Northern Ireland Court of Appeal held that coroners do have jurisdiction to carry out an inquest on a child that had been capable of being born alive.

Government announcement about independent investigations in future

On 28 November 2017, Health Secretary, Jeremy Hunt, made a statement to the House on the Government’s new strategy to improve safety in NHS maternity services. As part of this strategy, from April 2018, the Healthcare Safety Investigation Branch (HSIB) will investigate every case of a stillbirth, neonatal death, suspected brain injury or maternal death notified to the Royal College of Obstetricians and Gynaecologists (RCOG) Every Baby Counts programme, amounting to around 1,000 incidents per year.

Jeremy Hunt also said that he would work with the Ministry of Justice “to look closely into enabling, for the first time, full-term stillbirths to be covered by coronial law, giving due consideration to the impact on the devolved Administration in Wales”.

Commons Briefing papers CBP-8167

Authors: Catherine Fairbairn; Alex Bate; Oliver Hawkins

Topics: Coroners, Death, Health services, Registration of births, deaths and marriages

Share this page

Stay up to date

  • Subscribe to RSS feed Subscribe to Email alerts Commons Briefing papers

House of Commons Library

The House of Commons Library provides research, analysis and information services for MPs and their staff.