Myth: Preventing stillbirths is too expensive

Preventing stillbirths is not only affordable but cost-effective, with every dollar invested delivering more than triple the return by reducing medical, economic, and legal costs, while saving families and society from lifelong emotional and financial hardship (29).

The economic burden of stillbirth is substantial, extending far beyond the immediate tragedy. It includes increased healthcare use, long-term parental mental health needs, lost productivity at work, and significant costs from litigation (30,31).

Preventive measures such as improved antenatal care, safer sleep campaigns, and early identification of risks are low-cost, evidence-based, and already proven in some countries to reduce stillbirths (24,32). Improving antenatal care also brings wider benefits, including better detection and treatment of risks that overlap with fetal growth restriction, preterm birth, and maternal mortality.

While there are some costs involved in implementing such programmes—for example, the Saving Babies’ Lives Care Bundle in the UK was estimated at £166,000 per stillbirth prevented (33)—these must be weighed against the far greater costs of doing nothing.

Medical litigation alone is extremely expensive, with the US spending an average of $26 million annually over the past decade compared with just $12 million directed to stillbirth research (34). In Ireland, medico-legal cases related to perinatal deaths already contribute to an unsustainable financial trajectory for the health system (35).

References

(24) Andrews C, Boyle FM, Pade A, Middleton P, Ellwood D, Gordon A, et al. Experiences of antenatal care practices to reduce stillbirth: surveys of women and healthcare professionals pre-post implementation of the Safer Baby Bundle. BMC Pregnancy and Childbirth. 2024;24(1):520.

(29) ten Hoope-Bender P n, Stenberg K, Sweeny K. Reductions in stillbirths—more than a triple return on investment. The Lancet. 2016;387(10018):e14–6.

(30) Ogwulu CB, Jackson LJ, Heazell AEP, Roberts TE. Exploring the intangible economic costs of stillbirth. BMC Pregnancy and Childbirth. 2015;15(1):188.

(31) Veettil SK, Kategeaw W, Hejazi A, Workalemahu T, Rothwell E, Silver RM, et al. The economic burden associated with stillbirth: A systematic review. Birth. 2023;50(2):300–9.

(32) Andrews CJ, Ellwood D, Middleton PF, Gordon A, Nicholl M, Homer CSE, et al. Implementation and evaluation of a quality improvement initiative to reduce late gestation stillbirths in Australia: Safer Baby Bundle study protocol. BMC Pregnancy and Childbirth. 2020 Nov 13;20(1):694.

(33) 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.

(34) Gold KJ, Lens JW, Camacho EM, Heazell AEP. Malpractice payments for stillbirth and miscarriage in the United States from 2004 to 2023. American Journal of Obstetrics & Gynecology. 2025;232(6):e195–7.

(35) Forrest C, O’Donoghue K, Collins DC, O’Reilly S. Current Irish medicolegal landscape: an unsustainable trajectory. BMJ Open Quality. 2023;12(3):e002433.