The stillbirth rate in the United States may be higher than previously known, it was recently published research has found
A team at Harvard University looked at more than 18,800 cases of stillbirth, defined as fetal death at or after 20 weeks’ gestation. In more than 27 percent of these cases, the researchers were unable to identify a clinical risk factor, such as high blood pressure during pregnancy, gestational diabetes, or reduced fetal movement.
The study, which looked at private health insurance claims for births from 2016-2022, found there were about 6.8 stillbirths per 1,000 births — about 18 percent higher than federal data for a similar time period, which estimated 5.73 stillbirths for every 1,000 births. The rate was twice that for black patients, who had a stillbirth rate of 10.34 for every 1,000 births.
THE peer reviewed research, published in Journal of the American Medical Association in October 2025, it also showed that nearly 30 percent of documented cases occurred in people without personal health condition, life circumstances or fetal medical problem this would put them at greater risk for stillbirth.
“The fact that we are unable to fully reconcile these numbers points to a need for better stillbirth data and infrastructure and resources to collect better data,” said Haley Sullivan, the paper’s lead author. 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 the study revealed, and what those findings mean for pregnant women.
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 are higher than previously reported. The second key finding we see is that many stillbirths, especially stillbirths late in pregnancy, occur without an identified clinical risk factor. Overall, throughout pregnancy, most stillbirths 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?
A lot of people think of stillbirth as something that’s incredibly, incredibly rare and not something we should 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 occur with clinical risk factors, without the presence of clinical risk factors.
We just don’t know enough about stillbirth, in general. And we need more resources, more research, more attention to the issue of stillbirth before we can make progress in preventing stillbirth.
It is also important to emphasize that the US is general worse than other comparable countries in terms of mortality rate. So many clinicians, many researchers, many advocates believe that the US medical system, in general, the policy system and the epidemiological surveillance system could do to help identify the greater burden of stillbirth and target stillbirth reduction efforts.
(Read more: How Trump’s ‘Big, Beautiful Bill’ Fails Parents of Dead Babies—Analysis)
Are the risk factors you have identified things pregnant women can control?
It is not a helpful framework for people who have had a stillbirth—or for people in general—to believe that the pregnant woman is responsible for a stillbirth. … Clinical risk factors are difficult to control in the same way that many health conditions are difficult to control. And we don’t necessarily blame other health outcomes of someone who has hypertension on the fact that they have hypertension.
We also examine sociodemographic factors such as area-level measures of income and race. And we see significant differences there, and these are not things that people can control for themselves.
Similarly, we see significant differences between ages, and this is not something that anyone can control for themselves.
Which risk factors were most associated with stillbirth?
Fetal abnormality was the top, and this is 15.4 per 1,000 births. Next 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.
As for the lack of identifiable risk factors, do you have a sense of why?
That 30 percent figure is for pregnancies that occur at 40 or more weeks of gestation. All 40 weeks are considered the normal length of a pregnancy. For these later stillbirths, more research may need to be done into what exactly was the cause of these stillbirths, and possibly if there are risk factors that are missing that may be harder to measure or that we are not currently measuring.
(Read more: We had no idea how much physical danger stillbirth can cause)
Is there any other conclusion you would like to point out for other researchers?
It is always important to think of stillbirth as a [pregnancy] result. And often, some studies – for various reasons – only look at live births. I think stillbirths are very much worth studying.
