There are few moments when public services matter more than when a family is told that a pregnancy has ended or that a baby has died.
In that moment, people do not need slogans about compassionate care. They need privacy. Clear information. Time. A professional who knows what happens next. Someone who remembers the partner standing beside the bed. A route back into care when the first numb hours have passed.
Scotland has made meaningful progress in recognising that.
But recognition is not the same as reliable support.
The standard we should demand is simple: the quality of bereavement care should not depend on which hospital door a family walked through, whether a particular specialist happens to be on shift or whether the loss occurred before an arbitrary point that makes it easier for the state to count.
The latest numbers show why this cannot be treated as a niche issue
National Records of Scotland recorded 188 stillbirths in 2025, a rate of 4.2 per 1,000 live and still births. That was an increase from 159 stillbirths in 2024, although the 2025 rate remained low by historical standards.
There were also 150 infant deaths in 2025. Ninety-eight of those babies died in the first four weeks of life.
Those statistics are painful enough. They still do not measure the full scale of pregnancy loss.
A miscarriage before 24 completed weeks is not registered as a stillbirth in Scotland’s civil statistics. Scotland’s Memorial Book of Pregnancy and Baby Loss Prior to 24 Weeks provides an optional way for people to record and recognise such a loss, including losses that happened many years ago, but the entry has no legal status and is not a comprehensive statistical register.
That distinction matters.
If policymakers rely only on stillbirth and infant-death totals, many grieving families disappear from the national picture.
Scotland has improved the policy — now it has to prove the experience
The Scottish Government’s 2025 Delivery Framework for Miscarriage Care contains 34 actions intended to create a “One Scotland” approach.
It says people experiencing miscarriage should, where possible, be cared for in private spaces appropriate for bereavement and away from pregnant, labouring or postpartum patients. It calls for access to early-pregnancy expertise, psychological support and a graded model of care rather than expecting someone to endure repeated losses before the system takes them seriously.
In March 2026, NHS Scotland published a patient charter stating that support should begin after a first miscarriage. It includes information on bereavement and mental-health support, personalised advice and access to the optional Memorial Book.
These are important changes.
They should be recognised as such.
But a framework is a promise about what care should look like. A charter is a statement of what people should expect. Neither, by itself, proves that every NHS board has the staff, rooms, training, follow-up capacity and specialist services to deliver the same experience every time.
That is where the next phase of accountability must begin.
Families should not have to become their own care coordinators
After a loss, the system can become strangely administrative.
Who calls with results? Who explains what happened? Who discusses future pregnancy? Who helps when sleep disappears or anxiety becomes overwhelming? Who supports the partner who is trying to remain functional while grieving too? What happens when another pregnancy triggers fear rather than uncomplicated joy?
Families should not have to discover those answers by repeatedly phoning different departments.
Every family experiencing miscarriage, stillbirth or neonatal death should be offered a named point of contact and a written follow-up plan appropriate to their circumstances.
That does not mean forcing counselling onto everyone. Grief is not a disorder and there is no single correct way to experience it.
It means making support available before a person has to prove they are falling apart.
Partners and families cannot remain an afterthought
Pregnancy loss is physically experienced by one person, but its effects can spread through an entire family.
Partners may be expected to make calls, tell relatives, arrange practical matters, return to work and support the person who has undergone the physical loss while receiving little direct support themselves.
Other children in the family may understand that a baby was expected but struggle to understand why the future they had been told about has disappeared.
Bereavement care should therefore include partners and, where appropriate, siblings. Information should be available in accessible formats and different languages. Families should be told about memory-making, certification and memorial options without pressure to use them.
The choice to remember publicly, privately, symbolically or not at all belongs to the family.
The employment-law gap is difficult to defend
Under the current UK statutory scheme, eligible employees can take Parental Bereavement Leave when a child under 18 dies or following a stillbirth after 24 weeks of pregnancy.
That protection matters.
But the 24-week line creates an obvious inequality for miscarriage.
A person can experience a devastating pregnancy loss before 24 weeks and have no equivalent statutory parental-bereavement entitlement simply because the loss falls on the other side of the legal definition of stillbirth.
Some employers offer compassionate leave. Others may rely on sickness absence, annual leave or discretionary arrangements.
Grief should not depend on the generosity of a line manager.
Employment law is largely reserved to Westminster, so the Scottish Government cannot simply rewrite the UK statutory scheme on its own. But Scotland can still lead through NHS and public-sector employment policy, procurement expectations, advocacy and evidence showing what families actually need.
The UK Government should ultimately remove the arbitrary distinction in bereavement leave that leaves pre-24-week pregnancy loss outside the statutory scheme.
Measure care, not just policy
Scotland should publish board-level evidence showing whether its miscarriage and baby-loss commitments are actually being delivered.
That should include access to seven-day early-pregnancy advice or networked cover; availability of private bereavement spaces; specialist bereavement staff; time to follow-up; access to psychological support; provision for partners; complaints and patient experience; and implementation of the 2025 framework and 2026 charter.
The purpose is not to create league tables that shame maternity staff.
Frontline teams cannot provide rooms that do not exist or specialist time that has not been funded.
The purpose is to reveal gaps early enough for boards and ministers to fix them.
Compassion must survive contact with the system
Scotland deserves credit for the Memorial Book, the miscarriage framework and the new patient charter.
They represent a change in attitude: loss before 24 weeks is not nothing; a first miscarriage is not something a person should simply be told to endure; partners matter; privacy matters; bereavement care matters.
The next step is harder.
Make those principles dependable.
No parent should leave a hospital carrying grief and a collection of phone numbers with no idea who is responsible for them. No partner should be treated as a taxi driver and messenger. No family should discover that the support promised nationally does not exist locally.
And no one should be made to feel that the depth of their loss is determined by the number of completed weeks written in a medical record.
Baby loss does not end when a patient is discharged.
Our care for families should not end there either.
Sources
- National Records of Scotland — Adoptions, Births, Deaths, Marriages and Civil Partnerships in Scotland, 2025
- Scottish Government — Miscarriage care in Scotland: delivery framework
- Scottish Government / NHS Scotland — Miscarriage care: patient charter
- Scottish Government — Certification of pregnancy and baby loss prior to 24 weeks
- GOV.UK — Statutory Parental Bereavement Pay and Leave
- Social Security Scotland — Financial support for bereaved parents
Editorial note: This is an opinion article based on current official sources. Stillbirth and infant-death statistics do not measure all miscarriages or pregnancy losses before 24 weeks. Employment-law references describe the UK statutory position as checked on 31 August 2026.