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No matter when pregnancy loss occurs, and no matter which word is used to define the experience, it is a crushing time for the intended parents as they navigate their grief.
A pregnancy loss is usually described as either a “miscarriage” or a “stillbirth.” Although “a lot of people use these terms interchangeably,” says Dorothy Bestoyong, DO, an OB/GYN based in Orlando, Florida, “the biggest difference between [miscarriage and stillbirth] is the timeframe or gestational age at which the pregnancy loss occurs.”
The biggest similarity between miscarriage and stillbirth? Neither should ever be dismissed as a minor inconvenience. “Regardless of the time frame, the pain of the loss is still very significant for our patients,” says Dr. Bestoyong.
Even though the major distinction between miscarriage and stillbirth is timeline-related, it’s still important to educate yourself on their differences for the sake of a well-informed pregnancy journey.
What's the difference between a miscarriage and stillbirth?
A miscarriage is considered pregnancy loss before the 20-week mark, and stillbirth is considered a pregnancy loss after the 20-week mark, explains Dr. Bestoyong. While most miscarriages take place in the first trimester of pregnancy (within the first 13 weeks), a pregnancy loss is still deemed a miscarriage if it happens during the first half of the second trimester.
Other differences between miscarriage and stillbirth are their causes: Poorly managed medical conditions like diabetes, blood pressure concerns, and thyroid issues can cause miscarriage, says Dr. Bestoyong. But the most common reason for miscarriages, she says, are chromosomal abnormalities. About half to two-thirds of miscarriages in the first trimester are due to extra or missing chromosomes — or genetic cell structures — in the embryo.
Stillbirths, on the other hand, are usually the result of placental abnormalities like growth restriction and abruption, infection, or congenital anomalies, says Dr. Bestoyong.
According to the Centers for Disease Control and Prevention (CDC), stillbirth is additionally classified as either “early” (loss occurs between 20 and 27 weeks of pregnancy), “late” (loss occurs between 28 and 36 weeks of pregnancy), or “term” (loss occurs at 37 or more weeks of pregnancy).
Miscarriage and stillbirth treatment options
Miscarriage
If you’re experiencing a miscarriage, there are three common treatment options. Make sure you consult with your healthcare provider for the most informed choice.
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Expectant management: This is where the pregnancy tissue passes through the body on its own. Expectant management is most often used during the first trimester, and it’s a good option if the patient isn’t showing signs of infection.
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Medical treatment: A physician prescribes the medicines mifepristone and misoprostol to help the uterus expel the pregnancy from the body.
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Surgical treatment: A medical professional performs a dilation and curettage (D&C) to remove pregnancy tissue from the inside of the uterus.
Stillbirth
As with miscarriage, there are three common treatment options for stillbirth. Again, it’s critical to speak with your healthcare provider, because they can recommend the safest treatment plan for you. Be advised that unlike with a miscarriage, treating a stillbirth will feel similar to delivering a live baby.
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Induced labor: Once a stillbirth is diagnosed, it’s often recommended that labor begin as soon as possible. Your healthcare team will give you medicine that usually starts labor within two days of the pregnancy loss.
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Natural birth: Labor usually begins naturally within two weeks after a stillbirth occurs. Consult with your medical provider if this is your preference.
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Cesarean section (C-section): Though rare with stillbirths, an emergency C-section may be recommended if your health is at risk.
Pregnancy loss prevention
While pregnancy loss, especially in the early stages, tends to be due to the embryo’s chromosomes (meaning: It’s beyond your control), there are some things patients can do to help prevent miscarriages and stillbirth. This starts with establishing a solid partnership with your healthcare provider.
“If you’ve had more than two miscarriages,” says Dr. Bestoyong, “it is important to talk to your doctor about getting a workup on possible causes. Depending on what is found as the cause, addressing those issues can help prevent miscarriage.”
The best way to prevent stillbirth, she says, is to “ensure regular prenatal care and adhere to any necessary and recommended testing.” Dr. Bestoyong also recommends starting fetal kick counts in the third trimester (between 28 and 40 weeks). According to the Cleveland Clinic, 10 movements in one hour is considered typical fetal movement. But since every patient is different, speak to your healthcare provider about the best time to monitor fetal kicks, and how many you should be looking for.
Looking ahead
Even though Dr. Bestoyong confirms pregnancy resulting in a live, healthy baby is indeed possible after either a miscarriage or a stillbirth, there are other factors to consider before trying to conceive again. Pregnancy loss is a distressing time for anyone involved, so make sure you take as much time as you need to heal from the experience, both physically and mentally. Some studies suggest that people who wait one year after a stillbirth to conceive again have less depression and anxiety during pregnancy, but that’s a discussion for you and your healthcare provider.
If you’ve experienced pregnancy loss, remember that there is no grieving timeline. Seek help from a mental health professional, listen to your body’s needs, and ask for guidance from your physician. You’re entitled to physical and emotional support during this difficult period.
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram or Twitter.