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2021 US Stillbirth Scorecard

Stillbirth in the United States is most commonly defined as a fetal death occurring at 20 weeks or more gestation.  In 2021, 21,105 babies were stillborn across the US.  This is more than deaths due to SIDS and prematurity combined.  That number also represents roughly one quarter of all stillbirths occurring in high-income countries around the world. Unfortunately, the majority of these families will never know what caused their baby’s death. 

The stillbirth rate in the United States has remained largely unchanged for several decades and is higher than many comparable countries around the world.  During the years 2000 – 2015, the US had the second to lowest Annual Rate of Reduction for stillbirth out of 49 high-resource nations.  The top 5 nations had a reduction rate more than 10 times the US reduction rate of 0.4%. 

The emotional, financial, and physical impact on families and society has been well-documented.  Yet, the Lancet medical journal has called stillbirth “the most under-studied issue in medicine today.” 

The World Health Organization recently recognized the importance of fetal deaths as an indicator of global health by including fetal death rate targets for the first time in their Every Newborn Action Plan published in 2014. 

Stigma, lack of awareness, and fatalism have been identified as significant barriers to stillbirth prevention and bereavement support.  Adding to the issue, as noted by the Lancet Executive Summary, is that ‘no one organization takes responsibility for stillbirth.’  

The Stillbirth Scorecard is designed to bring stillbirth out of the shadows and raise our collective awareness about the number of families being impacted by these deaths every day.  We must first understand the problem before we can fix it.

The first step in this process is to understand the current status of stillbirth in the United States and in each state.  The documents presented here look at some key indicators of this status.   

Next steps in this effort will look at other factors that provide more information about the efforts to improve stillbirth prevention and bereavement care.  Examples may include the availability of a Certificate of Birth Resulting in Stillbirth, a Stillbirth Tax Credit, bereavement or support services, and more.  We will also be looking into more specific opportunities for improvement and highlight action items needed for progress.  

Download the full set of 2021 Scorecards

 2021 US Scorecard              2021 States by Stillbirth Rate

Click on each state below for the state scorecard.   Scorecard terms are defined below the map.

Scorecard Definitions 

  • The rate looks at the number of stillbirths per 1,000 live births in the same time frame for the geography indicated. 
  • The raw number indicates how many babies this represents in the year. 
  • Disparity ratio is a calculation to look at how far apart the rate is in a racial/ethnic group with the worst stillbirth rate from the racial/ethnic group with the best stillbirth rate.  The goal for this calculation is 1.0 which would mean no difference in outcomes across racial/ethnic communities.  A larger number reflects more significant disparity in pregnancy outcomes. 
  • The Cause of Death was added to this version of the scorecards.  They represent what is listed as an official cause of death on the fetal death reports, completed by the attending physicians and reported by each state to the CDC.  They can provide interesting information about what we know, and maybe more about what we don’t know about these tragic deaths.  It is important to note that these reports must be submitted within a few days of the baby’s death.  However, many test results are not available in this time.  Therefore, the diagnoses may be limited or inaccurate.  We feel this also tells a story about the data collection process.  Finally, there are many states with large numbers of ‘unknown’ or ‘unreported’ causes of death.  Our hope is that this can bring attention to the need for more and better testing as well as encouraging providers and government agencies to improve the testing and reporting systems.
  • The maternal age charts show the stillbirth rate for women at certain ages in that state. 
  • The gestational age charts show the number of babies who died at the various gestational ages. 
  • Autopsy Performed – percent of stillbirths evaluated with an autopsy per the fetal death report.
  • Stillbirth Tax Credit – indicates if the state offers a tax credit or deduction to families who experienced a stillbirth (as of 1/1/2023). 
  • Certificate of Stillbirth – indicates if the state offers an official document (Certificate of Birth Resulting in Stillbirth or similar) to recognize stillborn babies. 

Data Sources are identified on each state scorecard and include CDC Wonder Database and individual state offices of vital statistics.  CDC stillbirth data is only available through 2021.  The scorecards will be updated once additional data becomes available to the public

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