Stillbirths May Be More Common in U.S. Than Previously Known—Study

The stillbirth rate in the United States may be higher than previously known, recently published research has found.

A team at Harvard University reviewed more than 18,800 instances of stillbirth, which is defined as fetal death at or after 20 weeks of gestation. In more than 27 percent of these cases, the researchers could not identify a clinical risk factor like high blood pressure during pregnancy, gestational diabetes, or decreased fetal movement. 

The study, which looked at private health insurance claims for births from 2016-2022 found that there are about 6.8 stillbirths per every 1,000 deliveries—roughly 18 percent higher than federal data from a similar time period, which estimated 5.73 stillbirths per every 1,000 deliveries. The rate was double for Black patients, who had a stillbirth rate of 10.34 for every 1,000 deliveries. 

The peer-reviewed research, published in the Journal of the American Medical Association in October 2025, also showed that nearly 30 percent of the documented cases occurred in people with no personal health condition, life circumstance, or fetal medical problem that would have put them at a higher risk for a stillbirth.

“The fact that we aren’t able to fully reconcile these numbers suggests a need for better data on stillbirth, and infrastructure and resources to collect better data,” Haley Sullivan, the paper’s primary author, told Rewire News Group. 

RNG spoke with Sullivan, a doctoral student in health policy at Harvard University, about the surprising gap between federal and commercial insurance data revealed by the study, and what these findings mean for pregnant people.

The following conversation has been edited for length and clarity.

What would you say was the main discovery of your study?

The first is that stillbirth rates in the United States are high. In our study, we find that they’re higher than have been previously reported. The second main finding we see is that a lot of stillbirths, especially stillbirths late in pregnancy, are happening without an identified clinical risk factor. Overall, over the entire course of pregnancy, most stillbirths do have a clinical risk factor. But later in pregnancy, we find that nearly 30 percent don’t.

What should patients take away from these findings?

Many people think of stillbirth as something that is incredibly, incredibly rare, and not something that we need to devote resources to fixing. What we want people to take away from this study is that stillbirth still happens. It can happen early in pregnancy, it can happen late in pregnancy. It can happen with clinical risk factors, without the presence of clinical risk factors. 

We just don’t know enough about stillbirth, generally. And we need more resources, more research, more attention on the issue of stillbirth to be able to make progress on stillbirth prevention. 

It’s also important to highlight that the U.S. is generally doing worse than other comparable countries in terms of their stillbirth rate. And so a lot of clinicians, a lot of researchers, a lot of advocates feel that there’s a lot more that the U.S. medical system, generally, and policy system, and epidemiological monitoring system could be doing to help identify where the stillbirth burden is highest and target efforts to reduce stillbirth.

(Read more: How Trump’s ‘Big, Beautiful Bill’ Fails Parents of Stillborn Babies—Analysis)

Are the risk factors you’ve identified things that pregnant people can control?

It’s not a helpful framework for people who have had a stillbirth—or people in general—to think about the pregnant person as being to blame for a stillbirth. … Clinical risk factors are difficult to control in the same way that it’s difficult to control many health conditions. And we don’t necessarily blame other health outcomes of someone having hypertension on them having hypertension. 

We also look at sociodemographic factors, like area-level measures of income and race. And we see significant differences there, and those are not things that people are able to control about themselves. 

Similarly, we see significant differences across age, and that’s not something someone can control about themselves.

What risk factors were most closely related to stillbirths?

Fetal anomaly was the top one, and that’s 15.4 per 1,000 births. The next one is oligohydramnios, [or too little amniotic fluid], which has 15.15 stillbirths per 1,000 births. And the next highest clinical risk factor is chronic hypertension, which is 10.51 per 1,000 births.

In terms of the lack of identifiable risk factors, do you have a sense of why?

That 30 percent number is for pregnancies happening at 40 or more weeks gestation. And 40 weeks is considered the regular length of a pregnancy. For these later stillbirths, there might need to be more research done on exactly what the cause of those still births was, and potentially if there are risk factors that we’re missing, that might be harder to sort of measure, or that we’re not measuring right now.

(Read more: We Had No Idea How Much Physical Danger Stillbirth Can Cause)

Is there another conclusion you’d particularly want to highlight for other researchers?

It’s always important to think about stillbirth as a [pregnancy] outcome. And oftentimes, some studies—for various reasons—only look at live births. I think stillbirths are very much worth studying. 

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