Medical Certificate of Causes of Fetal and Neonatal Death

Information on completing a Medical Certificate of Causes of Fetal and Neonatal Death (HP4721) form as required under the Burial and Cremation Act 1964.

Guidance

When to use the certificate

The Medical Certificate of Causes of Fetal and Neonatal Death form is for infants who die within 28 days of birth and stillbirths. The requirements for completion of certificates for stillborn children are set out in the Burial and Cremation Act 1964 section 46A.

The certificate records information about the mother, pregnancy and delivery, in addition to information about the birthweight, gestation and cause of death of the baby.

Who completes the certificate

If no medical practitioner was present at the birth of a stillborn baby a midwife may complete the Medical Certificate of Causes of Fetal and Neonatal Death (HP4721) certificate instead.

Complete the Medical Certificate of Causes of Fetal and Neonatal Death form

You can order a pad of printed HP4721 forms online: Place an order

In the future, you will have the option to complete the form online on the Death Documents website.

The Medical Certificate of Causes of Fetal and Neonatal Death (HP4721) closely follows the format recommended by the WHO. Refer to the guidance in the section: Completing the form.

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