Stillbirths occur more often in the United States than previously reported—and a surprising share happen with no clinical warning signs—according to a new study led by researchers at the Harvard T.H. Chan School of Public Health and Mass General Brigham in Boston.
The study estimates that more than one in every 150 U.S. births ends in stillbirth—a figure higher than the current national average of one in 175 reported by the Centers for Disease Control and Prevention (CDC).
And, the team warn, In lower-income communities, that figure rises to 1 in 112 births.
The analysis, which examined over 2.7 million pregnancies between 2016 and 2022, represents one of the largest and most detailed investigations into stillbirth in the U.S. to date.
Researchers identified 18,893 stillbirths, then mapped their associations with a wide range of medical and socioeconomic factors—from chronic hypertension and diabetes to neighborhood income and racial composition.
Each year, stillbirths affect nearly 21,000 families in the U.S.—roughly one every 25 minutes. Yet, experts say, research and prevention efforts have lagged far behind those for other pregnancy outcomes.
"It is important for families who are expecting to know that stillbirth is rare, and the vast majority of pregnant women will deliver a heathy, live-born infant and not experience a stillbirth," paper author and health economist professor Jessica Cohen of the Harvard Chan School told Newsweek.
However, she cautioned, "stillbirth does still happen, even in healthy, low-risk pregnancies."
While nearly three-quarters of the stillbirths included in the study occurred in pregnancies with at least one known risk factor—such as chronic hypertension, low amniotic fluid or fetal anomalies—the remaining 27.7 percent occurred in pregnancies without any identified medical risk.
That number climbed sharply later in pregnancy: among stillbirths at 40 weeks or later, more than 40 percent had no clinical risk factors for such at all.
Previous studies on stillbirth have found similar results, and the American College of Obstetricians and Gynecologists (ACOG) advises inducing labour at or after 42 weeks of gestation, Cohen said, but there is limited data to guide decisions for pregnancies extending more than two weeks past the due date.
"ACOG does recommend induction of labor be considered and notes initiation of fetal surveillance tests may be indicated before 41 weeks, though these recommendations are mostly based on expert opinion," Cohen added.
"Although momentum toward improving stillbirth research and prevention efforts has increased in recent years, rates in the U.S. remain much higher than in peer countries,” said co-senior author Dr. Mark Clapp, a maternal-fetal medicine specialist at Massachusetts General Hospital.
“I hope this study will inform policy, practice changes and future research to ensure no person or family has to experience this outcome.”
The study also found stark socioeconomic differences in stillbirth risk. Rates were significantly higher in low-income areas, and among communities with a higher proportion of Black families—one in 95 births compared to White-majority areas.
However, rates did not vary significantly by whether the birth occurred in rural or urban regions, nor by measured access to obstetric care.
To help pregnant women identify or reduce their personal risk for stillbirth, Cohen said they should ask their pregnancy care providers about their risk level, available screenings to prevent stillbirth and key symptoms to monitor.
"Pregnant women know their bodies better than anyone and they should always err on the side of sharing their concerns with their medical team," she explained.
"That said, it is also critically important to understand that patients are not themselves responsible for preventing stillbirth."
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Reference
Sullivan, H. K., Sinaiko, A. D., Fox, K., Armstrong, J. C., Clapp, M. A., & Cohen, J. L. (2025). Stillbirths in the United States. JAMA. https://doi.org/10.1001/jama.2025.17392
