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Too big, too young, too risky: How diagnosis of the foetal body determines trajectories of care for the pregnant woman in pre‐viability second trimester pregnancy loss
Open accessAbstract
Women in the English National Health Service facing pre‐viability second trimester pregnancy loss through foetal death, premature labour or termination of pregnancy for foetal anomaly find themselves in a particular trajectory of care. This usually involves the requirement to labour and birth the foetal body and may involve undergoing feticide in cases of termination. Drawing on ethnographic research investigating women's experiences of second trimester pregnancy loss, I argue that the determining factor affecting care trajectories for the pregnant body is the biomedically diagnosed status of the foetal body. Foetal size, non‐viability and the potential for live birth during terminations all structure the healthcare options for the woman facing pregnancy loss in the second trimester. As such, the diagnostic classification of the foetal body in the context of gestational time determines the medical care afforded to the pregnant body. This results in specific consequences for women, whose experiences of, and choices around, second trimester pregnancy loss are constrained by diagnostic and classificatory decisions around the status of the foetal being before legal viability.
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“Prior to 24 weeks, the being which was lost is legally an embryo, foetus, pregnancy, part of the pregnant woman, whereas after 24 weeks it is a stillborn baby acknowledged by the state on the Stillbirth Register (Middlemiss, 2021).”
From Further Hierarchies of Loss: Tracking Relationality in Pregnancy Loss Experiences (2025) · cites this paper as Middlemiss, 2021
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Cited by
Further Hierarchies of Loss: Tracking Relationality in Pregnancy Loss Experiences
Middlemiss, A. L., & Kilshaw, S. (2025) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228231182273 · Cited by 20
“There are institutional and bureaucratic consequences of the categorisations such as access to maternity pay and forms of employment leave, the type of medical treatment available to women (Middlemiss, 2022), and choices about disposal of the body (Middlemiss, 2021).”
Self-citation
Metadata
- Authors
- Middlemiss, A. L.
- Affiliations
- University of Exeter (GB)
- Corresponding author
- Middlemiss, Aimee L.
- ORCID
- Middlemiss, Aimee L.
- Venue
- Sociology of Health & Illness
- Publisher
- Wiley
- Published
- 2021-11-24
- Volume
- 44
- Issue
- 1
- Pages
- 81-98
- ISSN
- 0141-9889 (ISSN-L)
- 1467-9566
- OpenAlex
- W3215332857
- Cited by
- 10
- References
- 0
- Citations by year
- 2025: 1 · 2024: 5 · 2023: 3 · 2022: 1
- FWCI
- 2.14
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Sociology of Health & Illness (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Open Research Exeter (University of Exeter) (submittedVersion, cc-by)
- Funders
- Economic and Social Research Council (ES/J50015X/1)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- second-trimester pregnancy loss, fetal death, premature labour, feticide, care pathways, gestational age, legal feasibility, women's experiences, medical classification, National Health Service
- MeSH terms
- Abortion, Induced, Female, Humans, Pregnancy, Pregnancy Trimester, Second, Prenatal Care, State Medicine, Pregnant People
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