Here’s a startling fact: stillbirth rates in the U.S. are higher than we’ve been led to believe, and a significant number of these tragedies occur without any obvious clinical red flags. But here’s where it gets even more alarming—nearly 21,000 families face this devastating loss every year, and almost half of these stillbirths, occurring at 37+ weeks, are believed to be preventable. Yet, research in this area remains shockingly limited. A groundbreaking study led by Harvard T.H. Chan School of Public Health and Mass General Brigham has shed new light on this underaddressed issue, revealing that the problem is far more widespread than previously thought.
Published in JAMA, this study stands out as one of the largest and most comprehensive investigations into stillbirths to date. Researchers analyzed over 2.7 million pregnancies across the U.S. between 2016 and 2022, using data from commercial health insurance claims, the Health Care Cost Institute, the American Community Survey, and the March of Dimes. Among these pregnancies, 18,893 stillbirths were identified—a rate of more than one in 150 births, significantly higher than the CDC’s national average of one in 175.
And this is the part most people miss: while 72.3% of stillbirths were linked to at least one clinical risk factor—such as obesity, hypertension, diabetes, or fetal anomalies—a staggering 27.7% occurred with no identifiable risk factors. This trend was particularly pronounced in pregnancies at 40+ weeks, where nearly 41% of stillbirths had no known clinical risks. These findings challenge the assumption that stillbirths are always tied to clear medical indicators, leaving many families and healthcare providers searching for answers.
The study also uncovered stark disparities. Families in low-income areas faced a stillbirth rate of one in 112 births, while in areas with higher proportions of Black families, the rate was one in 95 births. This raises a critical question: Are these disparities driven by social inequities, gaps in healthcare access, or other factors? The researchers emphasize the urgent need for further investigation into these socioeconomic variances.
Co-senior author Jessica Cohen, a professor of health economics, highlights the urgency: ‘Stillbirths impact thousands of families annually, yet research in this area is severely lacking. Our study underscores the need for better risk prediction and prevention strategies.’ Mark Clapp, a maternal-fetal medicine provider, adds, ‘The U.S. stillbirth rate remains higher than in comparable countries. I hope this research sparks policy changes, improved practices, and more focused studies to prevent these tragedies.’
But here’s the controversial part: While the study points to socioeconomic factors as key contributors, it stops short of prescribing solutions. Should we focus on improving access to prenatal care in underserved communities? Or is the issue more deeply rooted in systemic inequalities? The researchers call for a deeper dive into these questions, but the debate is far from settled. What do you think? Are we doing enough to address this crisis, or is there a glaring gap in our approach?
Led by first author Haley Sullivan, a Harvard Ph.D. student in Health Policy, and co-authored by Anna Sinaiko of Harvard Chan, this study is a call to action. It reminds us that behind every statistic is a family grappling with unimaginable loss. Let’s not just read about it—let’s talk about it. What changes do you think are needed to tackle this heartbreaking issue? Share your thoughts in the comments below.
