Stillbirth Policy

Stillbirth occurs in families of all races, ethnicities, and income levels, and to pregnant people of all ages. However, stillbirth occurs more commonly among pregnancies where the moms have certain risk factors, including those who:

• Are 35 years of age or older
• Are of low socioeconomic status
• Smoke cigarettes during pregnancy
• Have certain medical conditions, such as high blood pressure
• Are pregnant with more than one baby (such as twins or triplets)
• Have previously had a stillbirth³

Health disparities can be attributed to many underlying causes, including access to quality healthcare, pre-existing health conditions, and structural disparities. Inclusion of these drivers is an important part of creating prevention and education programs.

While 31.3% of all stillbirth causes are unknown, the majority are attributed to the following causes in order of frequency:

1. Placental, cord, and membrane complications: 25.6%
2. Maternal complications: 11.9%
3. Congenital malformations: 10.7%
4. Maternal conditions unrelated to pregnancy: 10.4%
5. All other causes: 10.1%¹

Stillbirth has significant impacts on moms and families. Studies have shown moms face increased risk of death and a nearly five-fold increase in maternal morbidity.⁴ Additionally, moms who suffer a stillbirth experience postpartum depression and anxiety at rates two to four times higher than those with a live birth.⁵

The psychological impact extends beyond moms to the broader family, with spouses, siblings, and grandparents experiencing grief, depression, and relationship tension. Studies show that couples report increased conflict and emotional distancing after a stillbirth. Families also experience social and economic repercussions, including stigma, isolation, and disruptions with employment and income, which can compound the health effects of stillbirth.⁶

Stillbirth also influences later pregnancies both medically and emotionally, and is associated with higher risks of adverse outcomes. Subsequent pregnancies carry increased risks of complications including fetal growth restriction, preeclampsia, placental dysfunction, preterm birth, low birth weight, and neonatal death.⁷

Fetal death certificates are the only national source of stillbirth data in the U.S. While the CDC offers guidelines as to how these deaths should be reported, states maintain the legal authority over reporting and thus have different approaches for data collection, personnel training, and resource dedication. In 2023, nearly half of reported stillbirths did not have a cause of death reported - this ranged from 17.2% in South Dakota to 72.2% in Vermont. This report also showed that some reporting areas had a high proportion of stillbirths with missing information on key indicators such as fetal presentation, delivery method, cigarette use, maternal morbidity, weight, or obstetric estimate of gestation.⁸

Inadequacy of stillbirth data collection

With many stillbirths preventable and about 30% of causes still unknown¹, policy reforms such as the Stillbirth Health Improvement and Education (SHINE) for Autumn Act (H.R.5469/S.2858) are critical to addressing the unacceptably high stillbirth rate in the U.S. The bill would take crucial steps toward prevention by improving data collection, strengthening research, raising public awareness, and expanding education by creating the first comprehensive federal-state partnership dedicated to reducing the incidence of stillbirth nationwide.

Key bill provisions

The SHINE for Autumn Act was introduced in Congress on September 18, 2025, by Sen. Cory Booker (D-NJ), Sen. Steve Daines (R-MT), Sen. Jeff Merkley (D-OR), Sen. Roger Wicker (R-MS), Rep. Young Kim (R-CA), Rep. Kathy Castor (D-FL), Rep. Robin Kelly (D-IL), and Rep. David Joyce (R-OH).

The bill would authorize $5 million for each fiscal year 2026 through 2030 to provide grants to states to support improved stillbirth data collection and reporting, including contributing risk factors. The SHINE for Autumn Act would also authorize $1 million in grants from fiscal years 2026 through 2030 for HHS, in coordination with healthcare providers, to develop guidelines and educational materials for state departments of health and vital statistic units on stillbirth data collection, data sharing, and educational materials on stillbirth prevention and stillbirth risk factors.

Maternal and Child Health Stillbirth Prevention Act (SPA) (Public Law No: 118-69)

SPA added stillbirth and stillbirth prevention to Title V of the Social Security Act, clarifying that state health agencies can use these funds for evidence-based programs, activities, and outcome research to reduce the incidence of stillbirth including tracking and awareness of fetal movements; improvement of birth timing for pregnant people with risk factors; initiatives that encourage safe sleeping positions for pregnant people; screening and surveillance for fetal growth restriction; efforts to achieve smoking cessation amongst pregnant people; community-based programs that provide home visits or other types of support; and any other research or evidence-based programming to prevent stillbirths.

Creation of the NICHD Stillbirth Working Group of Council

Created by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the Stillbirth Working Group was tasked with focusing on:

• Current barriers to collecting data on U.S. stillbirths
• Communities at higher risk for stillbirth
• Psychological impact and treatment for mothers following stillbirth
• Known risk factors for stillbirth

It issued its final report to HHS on March 15, 2023, with a follow-up implementation recommendations report in July 2024.