Stillbirth affects about 1 in 175 births in the United States, totaling roughly 21,000 babies each year. That makes it far more common than most people realize. In the U.S., stillbirth is defined as the loss of a pregnancy after 20 weeks of gestation but before birth, distinguishing it from miscarriage, which refers to pregnancy loss before 20 weeks.
Stillbirth Rates in the U.S.
The most recent CDC data puts the U.S. fetal mortality rate at 5.73 per 1,000 births, based on 21,105 fetal deaths recorded in 2021. To put that in perspective, if you were in a room with 175 people who had recently given birth, statistically one of them would have experienced a stillbirth. This rate has remained relatively stable in recent years, though it represents a meaningful decline from decades past.
The numbers are not evenly distributed across racial and ethnic groups. Black women experience stillbirth at a rate of 11.2 per 1,000 births, more than double the rate among white women (5.0) and Hispanic women (5.1). These disparities persist even after accounting for other health factors and reflect broader inequities in maternal healthcare access and quality.
Why Stillbirths Happen
A large proportion of stillbirths occur in otherwise healthy pregnancies, and in many cases the cause is never fully identified. Even in countries with access to autopsy and placental examination, roughly 15% of cases remain completely unexplained. When the definition of “unexplained” is broadened to include cases without a clear single cause, between one-third and one-half of all late-term stillbirths fall into this category.
When a cause can be identified, placental complications are the most common. The placenta may not develop properly, may separate from the uterine wall prematurely (a condition called placental abruption), or may fail to deliver enough oxygen and nutrients to the baby. Problems with the umbilical cord, including compression or knots, also account for a significant number of cases.
Other known causes include:
- Pre-eclampsia: a pregnancy condition involving dangerously high blood pressure
- Infections: bacterial infections that travel from the vagina to the uterus, as well as viral infections like rubella, cytomegalovirus, or parvovirus B19
- Genetic or physical conditions in the baby: structural abnormalities that affect development
- Pre-existing diabetes: both type 1 and type 2
- Obstetric cholestasis: a liver condition during pregnancy marked by severe itching
- Bleeding before or during labor
Who Is at Higher Risk
Certain factors increase the likelihood of stillbirth, though many stillbirths occur in women with no identifiable risk factors at all.
Pre-existing diabetes is one of the strongest individual risk factors. Women with type 1 diabetes have about 2.4 times the risk of stillbirth compared to women without diabetes, while women with type 2 diabetes face roughly 2.7 times the risk. That risk climbs even higher when the baby grows unusually large, a common complication of diabetic pregnancies. In those cases, the risk of stillbirth can be roughly four times higher than in non-diabetic pregnancies with large babies.
Advanced maternal age (generally over 35), obesity, smoking, and having had a previous stillbirth all increase risk as well. High blood pressure, whether pre-existing or pregnancy-related, is another significant contributor. The racial disparities mentioned earlier also represent a risk factor rooted in systemic differences in care rather than biology alone.
Monitoring That Can Reduce Risk
Not all stillbirths are preventable, but certain types of prenatal monitoring can catch problems early enough to intervene. Doppler ultrasound, which measures blood flow through the umbilical cord and uterine arteries, has been shown to reduce stillbirth risk by about 66% in studied populations when used routinely. Computerized fetal heart rate monitoring, a more advanced version of the standard heart rate check done at prenatal visits, has also shown significant reductions in fetal death compared to older monitoring methods.
Simpler tools matter too. Regular measurements of the uterus during prenatal visits help detect babies who aren’t growing properly, a warning sign that the placenta may be failing. Paying attention to fetal movement patterns is another practical screening method. A noticeable decrease in how often or how strongly your baby moves can signal distress, and reporting changes promptly gives your care team a chance to evaluate what’s happening.
For women with known risk factors like diabetes, high blood pressure, or a history of pregnancy complications, more frequent monitoring and earlier delivery planning are standard approaches. These don’t eliminate risk entirely, but they meaningfully reduce it.
How the U.S. Compares Globally
The World Health Organization defines stillbirth internationally as a baby who dies after 28 weeks of pregnancy but before or during birth, a later threshold than the 20-week cutoff used in the U.S. This difference in definitions makes direct comparisons tricky, since the U.S. count captures losses that many other countries would classify differently.
Even so, the U.S. rate is higher than in many other high-income countries. Nations with strong universal prenatal care systems, particularly in Scandinavia and parts of Western Europe, consistently report lower rates. The highest stillbirth rates globally are concentrated in sub-Saharan Africa and South Asia, where access to basic obstetric care remains limited. Worldwide, the total number of stillbirths (using the 28-week definition) is estimated at nearly 2 million per year.