Fetal mortality is defined as the death of a fetus prior to birth, regardless of gestational age. Based on survey data, more than a million fetal losses are estimated to occur annually in the United States, most of which are early fetal losses, also called miscarriages.1 Only fetal deaths at 20 or more weeks’ gestation—often called stillbirths— are generally reported by states in the National Vital Statistics System. In 2006, the latest year for which national data have been reported, there were 25,972 fetal deaths at 20 or more weeks’ gestation, for a rate of 6.05 fetal deaths per 1,000 live births plus fetal deaths. The number of fetal deaths is similar to the number of infant deaths (28,509 in 2006).2 
 
 Similar to trends for infant mortality, fetal mortality rates have generally declined over time. Since 1990, fetal mortality rates at 20 weeks or more have fallen by nearly 20 percent from 7.49 to 6.05 per 1,000 in 2006. Most of this decline is attributed to reductions in fetal mortality at 28 weeks or more, which declined from 4.30 to 2.97 per 1,000 between 1990 and 2006. 
 
 As with infant mortality, there are large differences in fetal mortality by race and ethnicity. In 2006, fetal mortality rates at 20+ weeks were more than twice as high among non-Hispanic Black women as for non-Hispanic White women (10.73 versus 4.81 per 1,000). The majority of this disparity (64 percent) was due to higher non-Hispanic Black fetal mortality rates at 20- 27 weeks’ gestation. Relative to non-Hispanic Whites, fetal mortality rates were also higher for non-Hispanic American Indian/Alaska Native and Hispanic women (6.04 and 5.29 per 1,000, respectively). 
 
 Causes of fetal death include preterm labor, birth defects, infection, placental problems, such as abruption or inadequate blood flow, and chronic conditions, such as hypertension and diabetes.3,4 Avoiding smoking and substance use, maintaining a healthy weight, and preventing and managing chronic conditions prior to and during pregnancy through preconception and prenatal care, may help to reduce risk of stillbirth.5 
 
 1 Ventura SJ, Curtin SC, Abma JC, Henshaw SK. Estimated pregnancy rates and rates of pregnancy outcomes for the United States, 1990-2008. National vital statistics reports; vol 60 no 7. Hyattsville, MD: National Center for Health Statistics. 2012.↑ 
 
 2 MacDorman MF, Kirmeyer SE, Wilson EC. Fetal and perinatal mortality, United States, 2006. National vital statistics reports; vol 60 no 8. Hyattsville, MD: National Center for Health Statistics. 2012.↑ 
 
 3 Stillbirth Collaborative Research Network Writing Group. Causes of death among stillbirths. JAMA. 2011 Dec 14;306(22):2459-68.↑ 
 
 4 March of Dimes . Stillbirth. Accessed: 08/01/2013.↑ 
 
 5 March of Dimes . Stillbirth. Accessed: 08/01/2013.↑ 
 
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 For the first time, stillbirths have slightly outnumbered deaths among infants before their first birthdays, a new report has found, ending a long period in which infant deaths were higher. 
 
 Infant mortality has declined nationwide by 11 percent since 2006, but the mortality rate for fetuses in the second half of pregnancy has stalled, according to a report issued on Thursday by the National Center for Health Statistics, part of the Centers for Disease Control and Prevention. 
 
 Lately, “we’ve made very little progress in reducing stillbirth in the U.S.,” said Dr. Robert L. Goldenberg, a professor of obstetrics and gynecology at Columbia University. 
 
 C.D.C. researchers found that 23,595 stillbirths occurred in 2013, compared with 23,446 infant deaths. Alabama, Mississippi, South Carolina, Puerto Rico and Guam had the highest rates of stillbirth, the report said. 

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– For as long as we have been gathering the data, more babies have died before reaching their first birthday (so-called infant deaths) than those who died in the second half of pregnancy (aka stillborns). Until now. Researchers with the National Center for Health Statistics yesterday released a report that shows while infant deaths have declined by 11% since 2006, the mortality rate of fetuses between 20 and 40 weeks gestation has stayed put in that time. Which means that in 2013, the number of stillbirths (23,595) actually surpassed the number of infant deaths (23,446) for the first time. Still, the difference is small. "There was less than 1% more fetal deaths," report author Elizabeth Gregory tells the New York Times. Between 1990 and 2006, the rate of stillbirths actually declined rapidly, falling nearly 20% from 7.49 deaths per 1,000 to 6.05, according to the Child Health USA 2013 report. And while genetic abnormalities, infections, and complications from placental or umbilical cord problems are often implicated, many of these deaths remain a mystery. Race seems to play a role, with black moms twice as likely as whites and Asians to have a stillborn—a disparity that persists even with access to early prenatal care. Stillbirths are also more common in women 35 and older, and most common in teens 15 and younger. And there are slightly more male stillbirths than female ones. (This woman chose to bathe and change her stillborn, whom she delivered at 38 weeks, because "that's all you have.")