Despite advances in prenatal care, stillbirths in the United States remain far more common than previously reported, with a significant number occurring without warning. A sweeping analysis of nearly 2.8 million pregnancies found that nearly 19,000 stillbirths occurred between 2016 and 2022—a rate higher than recorded in federal data.
The study, published Monday, reveals that nearly 30 percent of stillbirths happen in pregnancies that did not appear linked to any previously identified health or clinical risks. Additionally, stillbirth rates continue to fall unevenly along racial and socioeconomic lines, with Black families and poorer communities being hit hardest.
Mark Clapp, an obstetrician and maternal-fetal medicine specialist at Massachusetts General Hospital and one of the study authors, emphasized the urgent need for better screening and monitoring. “Even when we know someone is at increased risk, our tools for prevention are still limited,” Clapp said. “Every stillbirth represents an unimaginable loss, not just for the mother but for the entire family, and is a reminder of how far we still have to go.”
### A Comprehensive Analysis
Researchers from the Harvard T.H. Chan School of Public Health and Mass General Brigham described the study as “one of the largest, most data-rich studies of stillbirth burden to date.” They found that between 2016 and 2022, stillbirths occurred in:
– 1 in every 147 births overall, a higher rate than the roughly 1 in every 175 births reported by the Centers for Disease Control and Prevention (CDC).
– 1 in every 112 births among low-income families.
– 1 in every 95 births in areas with higher proportions of Black families compared with White families.
Jessica Cohen, co-senior author and professor of health economics at the Harvard T.H. Chan School of Public Health, suggested that the discrepancy between the study’s rates and CDC data might be due to known inaccuracies in fetal death certificate records, which don’t always accurately capture every stillbirth and vary in quality and definition across states.
The Harvard research reviewed pregnancy outcomes based on commercial health insurance claims, demographic data from the nonprofit Health Care Cost Institute—which tracks tens of millions of privately insured patients—as well as data from the U.S. Census Bureau’s American Community Survey and the March of Dimes, a nonprofit organization focused on maternal health and preventing infant deaths.
### Understanding Stillbirths
Stillbirth is defined as the death of a fetus after 20 weeks of pregnancy. Although federal data shows stillbirths have trended downward over the past 30 years due to medical improvements, the overall rate of decline has slowed.
More than 70 percent of stillbirths involved at least one clinical risk factor, such as obesity, substance use, or diabetes. However, many stillbirths occurred without warning or known complications. Rates were especially high in pregnancies complicated by chronic hypertension, fetal anomalies, or low amniotic fluid, and they increased sharply after 41 weeks of gestation.
“It’s astonishing that in our day and age, so many stillbirths happen with no identified risk factors,” Cohen said. “We have watches that track our sleep and stress, but we can’t always tell when a pregnancy is in trouble.”
### The Role of Structural Inequities
The study also highlighted that structural inequities—including where a person lives and the resources available in their community—remain strong predictors of stillbirth risk. Rates were higher in areas with more low-income households and larger Black populations, even among those with private insurance.
The authors suggest that social disadvantage continues to influence pregnancy outcomes beyond simple access to care. They note that even in cities with top hospitals, some women may still feel afraid to advocate for themselves or question medical decisions.
Harvey Kliman, director of the Reproductive and Placental Research Unit at Yale University, who was not involved in the study, identified systemic racism as a main factor behind these disparities. “There is no biological reason for there to be almost triple the rate of stillbirths in American Blacks compared to Whites,” Kliman said. “And that has been shown over and over again, and that disparity has not really improved.”
### Personal Stories: The Human Toll
#### “I saw my baby’s heartbeat stop”
Jaye Wilson, a 41-year-old nurse from Prince George’s County, Maryland, was 22 weeks pregnant in 2007 when her pregnancy ended due to placental abruption. On her commute home from her job at a pediatric community health center in New York City, she began bleeding on the train.
At the hospital, Wilson’s blood pressure was dangerously high, but she said staff questioned her. When she begged them to call her husband, a member of the medical team asked if he was her “husband or baby daddy.” Soon after, doctors confirmed she was losing her baby.
“On the ultrasound, I saw my baby’s heartbeat stop,” Wilson said. She named her daughter Nyiiema Renay. Wilson described how the loss was compounded by the degradation and disbelief she faced throughout her ordeal. Her experience underscored how deeply bias shapes Black women’s healthcare experiences. In response, she started the organization Melinated Moms in 2017 to provide resources to women at all stages of motherhood.
#### A Global Perspective
In 2023, nearly 2 million stillborn pregnancies occurred worldwide—approximately one in every 70 births—according to UNICEF. UNICEF defines stillbirth as babies born with no signs of life at 28 weeks of pregnancy or later.
Compared with peer nations, the United States has one of the highest stillbirth rates. For many families, these losses come suddenly and without explanation.
#### “I’ll never forget the look on my cat Gio’s face”
In October 2013, just two days before her due date, Samantha Banerjee, 40, from Katonah, New York, lost her daughter, Alana. Banerjee noticed changes in her baby’s movements in the days leading up to the tragedy—instead of usual kicks, she felt “a strange vibrating sensation.”
“I’ll never forget the look on my cat Gio’s face as I was walking out the door to the emergency room,” Banerjee recalled. “He had been with me throughout my entire pregnancy, and in that moment, I just knew something was wrong.”
Banerjee later founded PUSH for Empowered Pregnancy to raise awareness and support families affected by pregnancy loss.
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*Stillbirth remains a deeply personal tragedy affecting thousands of families every year. This study highlights the urgent need for improved screening, greater equity in healthcare access, and stronger support systems to help prevent these losses and support grieving families.*
https://www.phillytrib.com/news/health/far-more-pregnancies-end-in-stillbirth-than-previously-known-study-shows/article_48e67efd-7ca2-43fc-9cb5-267b904400f1.html
