25-06-2025
Stillbirth Is a Preventable Tragedy
In US prenatal care today, the entirety of patient education about one of the most critical signs of fetal wellbeing — movement — is often encapsulated by a single, vague question: "Is the baby moving?"
And this ambiguity is contributing to a persistent and preventable public health crisis: stillbirth.
Samantha Durante Banerjee, BS-Economics, BAS
Without standardized guidance, expectant parents are left uncertain about what fetal movement patterns mean, how to monitor them, and when to seek help. Worse still, many healthcare providers lack consistent protocols for evaluating or responding to reported changes.
I learned this the hard way in 2013, when my own daughter was stillborn just 2 days before her due date — despite an otherwise healthy pregnancy. Since then, more than 200,000 American families have experienced the same devastating loss. That's the equivalent of a full school bus of babies, every single day.
Stillbirth affects approximately 21,000 families in the US each year: a rate that has barely improved in two decades, branding us as one of the worst in the world. By contrast, countries like the UK and Australia have reduced stillbirth by 25% and 21%, respectively, through standardized national protocols and public health campaigns. Some nations now report fewer than two stillbirths per 1000 births, which is half the US rate.
At least one in four US stillbirths is preventable, including nearly half of all stillbirths at term. Yet despite this, our prenatal care guidelines lack a national standard for educating patients about or helping clinicians to assess one of the simplest, most commonsense indicators of pregnancy health: fetal movement.
Why Fetal Movement Matters to Clinicians
Fetal movement changes can be a late-stage warning sign of underlying complications, particularly those involving the placenta or umbilical cord — two of the most common contributors to stillbirth. Despite this, standard prenatal care and even high-risk care settings do not routinely screen for cord or placental abnormalities in a way that allows for proactive identification, monitoring, and if needed, intervention to prevent a tragic outcome.
As a result, fetal movement monitoring is one of the key tools at our disposal to help indicate a baby's and mother's well-being. The CDC includes 'baby's movement stopping or slowing' among its 15 urgent maternal warning signs.
Scientific literature consistently supports altered fetal movement — whether a decrease in frequency or strength, sudden rapid increase in intensity, or overall altered pattern — as a red flag for fetal compromise. Clinicians must be equipped not only to communicate this importance to patients, but also to respond with appropriate diagnostic and clinical action when changes are reported.
Monitoring fetal movement is simple, but currently, no universal protocol exists in the US for educating pregnant patients about fetal movement tracking or for responding to reports of decreased or altered movement. This is a critical gap in care and one that is disproportionately harming Black and Indigenous families, who experience more than twice the rate of both stillbirth and maternal mortality compared to their White peers.
A Path Forward for Clinical Leadership
Recognizing the urgent need for alignment with global best practices, PUSH for Empowered Pregnancy (PUSH) has partnered with Kicks Count UK and other worldwide organizations to help facilitate a fetal movement consensus statement offering clear recommendations for clinicians and patients alike. This international statement reinforces the critical role of fetal movement awareness, education, and timely clinical response as essential components of stillbirth prevention.
While parent-led advocacy organizations like PUSH continue public awareness efforts, it is ultimately clinical institutions that hold the power to drive the systemic change our country needs. The American College of Obstetricians and Gynecologists, the Society for Maternal-Fetal Medicine, and other professional bodies are uniquely positioned to:
Develop and implement national guidelines for fetal movement monitoring and response, following proven models from countries with lower stillbirth rates
Ensure the integration of patient education on fetal movement into standard prenatal care practices
Improve training and protocols to ensure immediate, evidence-based clinical response to reported changes in movement
Enhance early detection of stillbirth risk factors through targeted screening (eg, fetal growth restriction, placental insufficiencies, cord abnormalities) and better risk assessment tools
Resources for Clinicians
Despite lagging US efforts to prioritize stillbirth prevention, resources are available today for clinicians seeking to integrate global best practices. Evidence-based tools, accredited interdisciplinary training, and clinical communication resources are available through PUSH, as a well as free downloadable patient education materials.
These resources are intended to supplement clinical care, not replace it; and they can support your efforts to provide more informed, proactive, and equitable prenatal care. Stillbirth is not inevitable. Other countries have reduced their rates dramatically by adopting straightforward, cost-effective interventions to save thousands of lives. We can do it, too.
