US Stillbirth Rate Drops Slightly, but Inequities Persist

 

The United States saw a small but encouraging improvement in its stillbirth rate last year, according to newly released figures from the US Centers for Disease Control and Prevention (CDC). After several years marked by uncertainty and fluctuation, the national stillbirth rate dropped by about 2% in 2024.

Even with this progress, the numbers remain sobering. Nearly 20,000 pregnancies ended in fetal death last year — translating to slightly more than 5.4 stillbirths per 1,000 live births and pregnancies that reached at least 20 weeks. Although this is the lowest level recorded in decades, federal officials note that it does not mark an official historic low.

A Long-Term Decline Interrupted by Recent Setbacks

Over the past three decades, the country has made gradual progress in reducing stillbirths. The national rate fell from 7.5 per 1,000 in 1990 to 5.7 in 2019. However, that progress was disrupted when the rate edged upward during the first year of the Covid-19 pandemic. Since then, year-to-year numbers have been uneven, with the 2024 decline essentially bringing the nation back to levels similar to 2022.

Major Improvements in Three States

The CDC report highlights three states that contributed significantly to the national progress.
• Colorado recorded a 14% decrease.
• Utah saw a 16% reduction.
• Mississippi experienced the largest drop — a notable 21% decline.

Despite that improvement, Mississippi still faces the highest stillbirth rate in the country at 7.8 per 1,000. State health leaders have been sounding the alarm. Earlier this year, Mississippi declared a public health emergency due to the rising infant death rate. This declaration allows the state to mobilize funding and expand programs to address maternal and infant care gaps — including efforts to reduce maternity care deserts and strengthen coordinated care systems.

Experts emphasize that although third-trimester stillbirths saw improvement nationwide in 2024, far more work is required to ensure consistent progress.

A Public Health Issue That Mirrors Infant Mortality

“Stillbirth affects a similar number of families as infant mortality each year,” said Ashley Stoneburner, director of applied research and analytics at March of Dimes. She noted that many of the risk factors linked to early infant deaths also contribute to stillbirths, making it a deeply intertwined public health challenge.

In response, the National Institutes of Health created a five-year, $37 million Stillbirth Research Consortium in September. The initiative aims to better understand the causes of stillbirth and support prevention strategies.

Research indicates that roughly one-quarter of stillbirths may be preventable. However, the majority — as many as 60% — remain unexplained even after common causes such as congenital conditions, genetic issues, and known pregnancy complications are ruled out.

Health, Environmental, and Social Risk Factors

A range of health issues can elevate the risk of stillbirth, including diabetes, high blood pressure, obesity, and substance use during pregnancy. Stoneburner also pointed to environmental and psychological triggers — such as exposure to extreme heat, pollution, and high stress levels. Social factors play a powerful role as well, with limited access to medical care and socioeconomic inequality significantly affecting outcomes.

The March of Dimes’ 2025 report card underscored troubling trends, such as fewer pregnant women starting prenatal care early and ongoing disparities that leave certain communities at heightened risk.

Persistent Inequities Across Racial Groups

CDC data continues to show stark racial inequities. Stillbirth rates among Black mothers and Native Hawaiian or Pacific Islander mothers remain the highest in the country at about 10 fetal deaths per 1,000 — roughly double the rate seen among White, Asian, and Hispanic mothers. These gaps highlight the urgent need for targeted interventions and improved access to quality maternal care.