Stillbirth Prevention Navigator

Match a pregnancy's risk profile to the prevention strategies that actually have published evidence — with every number traceable to its source.

What this tool does

Stillbirth has many distinct causes, so no single intervention prevents it. This navigator lets you enter a pregnancy's risk factors, then returns the evidence-based prevention and surveillance strategies relevant to that profile — graded by strength of evidence. It is built on the 2026 Clinics in Perinatology prevention review, the SBL (England) and Safer Baby Bundle (Australia) evaluations, and the ACOG/SMFM stillbirth consensus. It does not compute an individual probability of stillbirth; it organizes what the evidence supports.

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Evidence base — 4 publications

Silver & Reddy 2026 · SBL England · Safer Baby Bundle · ACOG Consensus No. 10. Full Vancouver citations with annotations.

Evidence base

The publications this tool is built on. Every figure shown anywhere in the navigator traces to one of these sources.

PUBLICATIONS USED IN THIS TOOL

1

Silver RM, Reddy UM. Prevention of Stillbirth. Clin Perinatol. 2026;53(1):135–147.

Anchor · Prevention Framework

Provides the prevention architecture: placental insufficiency as leading cause (up to 40%), risk stratification limits, and graded intervention evidence (aspirin, induction, DFM, bundles).

2

Widdows K, Roberts SA, Camacho EM, Heazell AEP. Stillbirth rates, service outcomes and costs of implementing NHS England's Saving Babies' Lives care bundle in maternity units in England: a cohort study. PLoS One. 2021;16(4):e0250150.

Cohort · Bundle Outcomes & Cost

>463,000 births. Stillbirth 4.2→3.4/1000 (aRR 0.80) with parallel rises in induction, cesarean, scans and SGA detection. Source of the "intervention has trade-offs" data.

3

Andrews CJ, Ellwood D, Middleton PF, et al. Implementation and evaluation of a quality improvement initiative to reduce late gestation stillbirths in Australia: Safer Baby Bundle study protocol. BMC Pregnancy Childbirth. 2020;20:694.

Bundle · 5 Elements

Defines the 5 Safer Baby Bundle elements (smoking, FGR, DFM, safe sleep position, timing of birth) and the late-gestation reduction target (2.4→1.9/1000).

4

Management of stillbirth. ACOG Obstetric Care Consensus No. 10. Obstet Gynecol. 2020;135:e110–132.

Guideline · Risk Factors & Recurrence

Source of condition-specific stillbirth rates, recurrence risk (OR 4.83), and the subsequent-pregnancy surveillance protocol.

🔬 Primary trials cited within the anchor review

Key intervention figures in this tool originate in these primaries (cited within source ①) and were independently verified against PubMed / the original reports.

Hoffman MK, et al. Low-dose aspirin for the prevention of preterm delivery in nulliparous women with a singleton pregnancy (ASPIRIN): a randomised, double-blind, placebo-controlled trial. Lancet. 2020;395(10220):285–293. — perinatal mortality 45.7 vs 53.6/1,000; RR 0.86 (0.73–1.00).
Po' G, Oliver EA, Reddy UM, Silver RM, Berghella V. The impact of induction of labor at 39 weeks in low-risk women on the incidence of stillbirth. Am J Obstet Gynecol. 2020;222(1):88–90. — ~883 US stillbirths/yr preventable; NNT ≈1,675 inductions.

Step 1 — Maternal & medical factors

Select all that apply. Estimated stillbirth rates shown are from ACOG Consensus No. 10 (per 1,000 births) and serve only to rank surveillance priority — they are not additive.

Maternal medical conditions

Demographic / constitutional

Step 2 — Current pregnancy & fetal factors

These factors most often act through placental insufficiency — the leading cause of stillbirth in high-resource settings, up to 40% of cases (Silver & Reddy 2026).

Placental / fetal

Pregnancy characteristics

Step 3 — History & modifiable factors

Modifiable factors are where prevention has the strongest, simplest evidence. Prior obstetric history drives subsequent-pregnancy surveillance.

Obstetric history

Modifiable behaviors

Step 4 — Evidence-based prevention strategy

Strategies relevant to the selected profile, grouped by strength of evidence. Every figure cites its source.

📋 Stillbirth prevention bundles — the population-level evidence

Several countries package these strategies into "bundles." They are associated with reduced stillbirth, but — importantly — efficacy of the bundle as a whole has not been definitively proven, and implementation carries trade-offs.

Saving Babies' Lives (SBL) — England

Across >463,000 births, stillbirth fell from 4.2 to 3.4 per 1,000 (aRR 0.80; 95% CI 0.70–0.91) — faster than the national decline over the same period (4.2→3.7). Four elements: smoking cessation, FGR risk assessment/surveillance, reduced-fetal-movement awareness, and effective fetal monitoring in labour.

↑25% ultrasound scans (aRR 1.25) ↑59% SGA detection (33.8→53.7%) ↑20% induction (aRR 1.20) ↑10% emergency CS (aRR 1.10)

Widdows et al. PLoS One 2021;16(4):e0250150. Reduction could not be definitively attributed to the bundle (no step-change detected). Cost ≈£140/birth.

Safer Baby Bundle (SBB) — Australia

Modelled on SBL with five elements, targeting a ≥20% reduction in late-gestation stillbirth (2.4→1.9 per 1,000):

Support women to stop smoking in pregnancy
Improve detection & management of fetal growth restriction
Raise awareness & care for decreased fetal movements
Improve maternal safe going-to-sleep position (side) in late pregnancy
Improve decision-making about timing of birth for women with risk factors

Andrews et al. BMC Pregnancy Childbirth 2020;20:694. ~150 lives/year projected if scaled nationally.

📊 Reference: estimated stillbirth rates by condition

ACOG Obstetric Care Consensus No. 10, Table 1. Rate per 1,000 live births + stillbirths. Rows matching this profile are highlighted.

Condition	Est. rate /1,000

Stillbirth Prevention Navigator

What this tool does

An honest caveat from the evidence