Most stillbirths are not inevitable. While not every case can be prevented, a combination of prenatal care, lifestyle changes, and awareness of warning signs can meaningfully lower the risk. Nearly 2 million stillbirths occur worldwide each year, and over 40% happen during labor, which means that timely medical intervention plays a significant role. Here’s what the evidence says about the steps you can take.
Track Your Baby’s Movements After 28 Weeks
One of the most accessible tools you have is paying attention to how your baby moves. Fetal movement counting, often called “kick counts,” is something you can do at home starting around 28 weeks. There’s no single universal method. Some providers recommend counting how long it takes to feel 10 movements, while others ask you to track movement during a set time window each day. The key is learning what’s normal for your baby and noticing when something changes.
A sudden decrease in movement doesn’t always mean something is wrong, but it’s one of the few early signals you can detect on your own. If your baby is moving less than usual, contact your provider that same day. Don’t wait until your next scheduled appointment. Providers can run additional monitoring, typically starting between 32 and 34 weeks for pregnancies with risk factors, though testing may begin earlier when concerns are more serious.
Attend All Prenatal Screenings
Routine prenatal visits exist partly to catch conditions that raise stillbirth risk before they become dangerous. Two of the most important screening targets are gestational diabetes and preeclampsia, both of which can impair blood flow to the placenta if left unmanaged.
Gestational diabetes screening is recommended for all pregnant people at 24 weeks of gestation. The test involves drinking a glucose solution and having blood drawn to check how your body processes sugar. If caught early, gestational diabetes is highly manageable through diet, activity, and sometimes medication. Uncontrolled blood sugar, on the other hand, can lead to an overly large baby, placental problems, and increased stillbirth risk.
Preeclampsia, a condition marked by high blood pressure and organ stress, is monitored through blood pressure checks and urine tests at every prenatal visit. For people at high risk of preeclampsia (due to a previous history, chronic hypertension, kidney disease, or carrying multiples), low-dose aspirin is recommended starting between 12 and 28 weeks of pregnancy, ideally before 16 weeks, and continuing daily until delivery. This simple intervention helps protect placental blood flow.
Detecting a Baby That Isn’t Growing Well
Fetal growth restriction, where a baby’s weight falls below the 10th percentile for gestational age, roughly doubles the risk of fetal death compared to normally grown babies. The challenge is that current screening methods miss a striking number of these cases. Studies estimate that 50 to 90% of growth-restricted babies go undetected until delivery.
The standard screening tool, fundal height measurement (where your provider measures your belly with a tape measure), catches only about 43% of babies that are too small. Ultrasound measurements of the baby’s abdomen are significantly more accurate, detecting 85 to 100% of growth-restricted babies depending on the method used. If you have risk factors for growth restriction, such as high blood pressure, a history of a small baby, or smoking, ask your provider whether additional ultrasound monitoring is appropriate. Detecting a growth-restricted baby early gives your medical team time to increase monitoring and plan delivery timing.
Sleep on Your Side After 28 Weeks
After 28 weeks of pregnancy, going to sleep on your back may slightly increase the risk of stillbirth. When you lie flat on your back, the weight of the uterus can compress a major vein that returns blood to your heart, reducing blood flow to the placenta. Research estimates that if all pregnant people avoided falling asleep on their backs, late stillbirth rates could drop by about 6%.
The recommendation is specifically about the position you fall asleep in, not every position you find yourself in overnight. If you wake up on your back, simply roll to your side. Placing a pillow behind you can help you stay on your side through the night. Either side works, though the left is often suggested because it maximizes blood flow.
Quit Smoking and Avoid Secondhand Smoke
Smoking during pregnancy is one of the most well-documented modifiable risk factors for stillbirth. A large meta-analysis found that smoking raises the odds of stillbirth by 47% overall. The risk scales with how much you smoke: fewer than 10 cigarettes a day is associated with a 9% increase, while 10 or more cigarettes a day raises the odds by 52%.
Quitting at any point during pregnancy reduces risk, and quitting earlier provides more protection. If you’re struggling to stop, your prenatal provider can connect you with cessation support that’s safe during pregnancy. Avoiding secondhand smoke exposure matters too, since it exposes you to many of the same harmful compounds.
Consider Air Quality
Emerging population-level data suggests a link between fine particulate air pollution (PM2.5) and stillbirth rates. One national study covering 2015 to 2018 found that for every 1 microgram per cubic meter increase in average annual PM2.5 concentration, stillbirth rates rose by about 3%. While individual-level recommendations are still developing, practical steps include checking local air quality indexes on high-pollution days, using air filtration at home, and limiting prolonged outdoor exertion when air quality is poor, especially if you live in an area with consistently elevated pollution.
Manage Chronic Health Conditions
Pre-existing conditions like chronic high blood pressure, diabetes, thyroid disorders, and autoimmune conditions all raise stillbirth risk when poorly controlled. If you have any of these, getting them as well-managed as possible before conception, and maintaining close follow-up throughout pregnancy, is one of the most protective steps available. This often means more frequent prenatal visits, additional blood work, and sometimes extra ultrasounds to monitor fetal growth.
Obesity is another independent risk factor. While significant weight loss isn’t recommended during pregnancy, reaching a healthier weight before becoming pregnant can reduce complications including preeclampsia, gestational diabetes, and growth restriction, all of which feed into stillbirth risk. Even modest improvements in fitness and nutrition before pregnancy offer measurable benefits.
Understand Timing of Delivery
Stillbirth risk increases as pregnancy extends beyond the due date. For pregnancies with specific risk factors, providers may recommend induction before 40 weeks to reduce this risk. The exact timing depends on your individual situation: someone with gestational diabetes, preeclampsia, or growth restriction may be offered induction at 37 to 39 weeks, while a low-risk pregnancy might be monitored closely and offered induction at 39 to 41 weeks.
If your provider recommends waiting, ask what additional monitoring will be done in the meantime. Non-stress tests and biophysical profiles (ultrasound assessments of the baby’s movement, breathing, and fluid levels) are standard tools for checking on babies in the final weeks. Knowing the plan and understanding what each test measures can help you feel more in control during the most anxious stretch of pregnancy.
What You Can’t Control
Some causes of stillbirth, including chromosomal abnormalities, umbilical cord accidents, and unexplained placental failure, remain beyond anyone’s ability to prevent. This is an important reality to hold alongside all the actionable steps above. Doing everything right does not guarantee a specific outcome, and experiencing a stillbirth does not mean something was done wrong. The goal of prevention efforts is to reduce population-wide risk and catch treatable problems early, not to place the burden of an unpredictable tragedy on individual parents.