Preventing Stillbirth: The Full Picture

Stillbirth prevention is not one thing you do in the third trimester. It is a series of steps — before pregnancy, early in pregnancy, all the way through, and even after a loss. Here is what you and your care team can do at each stage.

Why this tool exists

You may have seen a popular health graphic that lists a few risk factors — weight, smoking, age, diabetes — and a few late-pregnancy tips. That is true, but it is only a slice of the story. It can leave you thinking prevention is just about managing risk factors once you are already pregnant.

A large 2025 study of more than 2.7 million U.S. pregnancies found that nearly half of stillbirths after 37 weeks may be preventable — and that many happened in pregnancies with no known risk factor at all. In other words, "low risk" does not mean "no risk." That is why every pregnant person, not just high-risk ones, benefits from knowing the full picture below.

~21,000

stillbirths in the U.S. each year

JAMA Patient Page

~1 in 150

births end in stillbirth — more than once thought

Sullivan, JAMA 2025

~½

of term stillbirths may be preventable

Sullivan, JAMA 2025

Your prevention timeline

Tap each stage to see what helps. Check off the steps that apply to you — they will gather into a plan at the bottom you can print and bring to your appointment.

A note on access — because effort is not enough alone

Knowing what to do only helps if you can actually get the care. Stillbirth happens more often where prenatal care, ultrasound, specialist visits, and quick triage are hard to reach. You have the right to ask for more.

Ask early for a referral to a maternal-fetal medicine (high-risk) specialist if you have a health condition or a past loss.
If transportation, time off, or cost are barriers, tell your clinic — many have help, telehealth visits, or social work support.
If your concern about movement or symptoms is brushed off, it is okay to ask again, bring someone with you, or go to labor and delivery to be checked.

My Prevention Plan

The steps you checked above appear here. Print it or save it as a PDF and share it with your obstetrician or midwife.

▶ Evidence behind this tool (sources)

1. American College of Obstetricians and Gynecologists; Society for Maternal-Fetal Medicine. Management of stillbirth: Obstetric Care Consensus No. 10. Obstet Gynecol. 2020;135(3):e110–e132. doi:10.1097/AOG.0000000000003719. PMID 32004519. The main U.S. guideline. Sources the risk factors, the role of antenatal surveillance, and the after-a-loss evaluation (autopsy, placental pathology, genetic testing) to prevent recurrence.

2. Sullivan HK, Sinaiko AD, Fox K, Armstrong JC, Clapp MA, Cohen JL. Stillbirths in the United States. JAMA. 2025;334(22):2033–2035. doi:10.1001/jama.2025.17392. PMID 41143832. Large 2025 analysis (2.7 million pregnancies). Source for "~1 in 150 births," "nearly half of term stillbirths preventable," and the finding that many occur with no known risk factor.

3. Norman JE, Heazell AEP, Rodriguez A, et al. Awareness of fetal movements and care package to reduce fetal mortality (AFFIRM): a stepped wedge, cluster-randomised trial. Lancet. 2018;392(10158):1629–1638. doi:10.1016/S0140-6736(18)31543-5. PMID 30269876. Large randomized trial. Did not show a significant drop in stillbirth from a movement-awareness package (adjusted OR 0.90, 95% CI 0.75–1.07) — the honest basis for not overselling kick counting alone.

4. Mangesi L, Hofmeyr GJ, Smith V, Smyth RMD. Fetal movement counting for assessment of fetal wellbeing. Cochrane Database Syst Rev. 2015;(10):CD004909. doi:10.1002/14651858.CD004909.pub3. PMID 26467769. Cochrane review. Evidence was insufficient to show routine formal counting reduces stillbirth — but reduced or changed movement remains a warning sign needing prompt evaluation.

5. Silver RM, Stone JL. A United States stillbirth prevention bundle. Am J Obstet Gynecol. 2024;231(2):147–149. doi:10.1016/j.ajog.2024.04.009. Supports a multi-step prevention approach (growth surveillance, delivery timing, movement response) rather than risk-factor management alone.

6. Stillbirth. JAMA Patient Page. JAMA Network. jamanetwork.com. The widely shared patient graphic this tool expands upon; source for the ~21,000 annual stillbirths figure.

This tool is for education and does not replace your obstetrician or midwife. It does not diagnose any condition or give personal medical advice. The big trials (AFFIRM, Cochrane) did not prove that formal kick counting by itself lowers stillbirth — but a clear drop or change in your baby's movement is a real warning sign that should always be checked promptly. When in doubt, contact your provider or go to labor and delivery.

This is a sensitive topic. If you have lost a baby, or are struggling, please reach out to your care team or a support organization — you do not have to carry it alone.