A new study led by Cande Ananth, chief of epidemiology and biostatistics in the department of obstetrics, gynecology and reproductive sciences at Rutgers Robert Wood Johnson Medical School, finds that the decades-long effort to lower the stillbirth rate in the United States has stalled, as has progress in closing a persistent gap in stillbirths experienced by Black women compared with White women.
Dr. Ananth and a team of Rutgers obstetricians examined changes in stillbirth rates between 1980 and 2020. They found that total stillbirth rates in the U.S. declined steadily between 1980 and 2005, backed by advances in prenatal care and maternal health. For every 1,000 women who delivered in 1980, ten of those pregnancies ended in stillbirth. By 2005, the figure had declined to about five per 1,000. But since then, the researchers found, improvements have flatlined and the rate today is about the same as it was more than a decade ago.
But despite overall progress since 1980, the racial gap remained. The researchers found that despite efforts to reduce structural racism and increase healthcare access to women of color, the disparity in stillbirth rates for Black women compared with White women remained unchanged during the 40-year period. The rate for Black women was about twice the rate of White women in 1980 (17.4 versus 9.2 per 1,000 births) and remained twofold in 2020 (10.1 versus 5.0 per 1,000 births).
“Over the last 40 years, we have reduced certain risk factors for stillbirth, such as smoking and alcohol use before and during pregnancy, but these gains have been countered by substantial increases in other risk factors, like obesity and structural racism,” Dr. Ananth said.
The full study, “Evolving Stillbirth Rates Among Black and White Women in the United States, 1980–2020: A Population-Based Study,” was published in The Lancet Regional Health: Americans. It may be accessed here.
