“What we’ve done is cause an unintended spike in stillbirth while trying to protect [pregnant women] from COVID-19.”

So says Jane Warland, a nurse-midwife and researcher at the University of South Australia, in a story for Nature, chronically a rise in stillbirths that researchers have begun to see in some parts of the world.

Results from around the world

A large study out of 9 hospitals in Nepal has found that stillbirth rates increased in the first month of the COVID-19 induced lockdown. After lockdown, the researchers saw an increase in premature births and Cesarean sections. The rate of stillbirths went from 14 per 1,000 births to 21 per 1,000 births. The researchers did not see a rise in the overall number of stillbirths, but this might be because of an apparent steep drop in the number of babies born in a hospital.

“Institutional childbirth reduced by more than half during lockdown,” the authors stated, “with increases in institutional stillbirth rate and neonatal mortality, and decreases in quality of care.” So, fewer babies were born in a hospital, and of those that were, more died. And all of them received worse care than before the lockdown. There were no reports of the pregnant women having been infected with the coronavirus.

Why is this happening?

The authors have several theories: Pregnant women in more dire situations may have gone to the hospital, while women who could, delivered at home, thus skewing the statistics. They also theorized that because of lockdowns, there might have been delays in care.

The Centers for Disease Control and Prevention defines stillbirth as the death of a fetus or baby before or during delivery. Pregnancy lasts about 40 weeks. Losing the fetus in the first 20 weeks is called a miscarriage. After that, it is called a stillbirth. According to data from 2014, the stillbirth rate in the United States is 1 in 160 births.

The increase in stillbirths appears to be happening globally. A report from St George’s Hospital in London, England, found that the stillbirth rate increased from a little over 2 per 1,000 in mid-2019 to a little over 9 per 1,000 in the first half of 2020. Only 1 pregnant woman tested positive for SARS-CoV-2. Asma Khalil, MD, professor of obstetrics at St George’s and an author of the study, wrote in a tweet that “[T]he observed increase in stillbirth during the Covid-19 pandemic is alarming, but it confirms the anecdotal reports of excess cases of unexplained stillbirth by a number of clinicians.”

Changing statistics

Some reports counter these statistics or at least show that premature births are going down.

More research will be needed to consider women who had their babies at home or in smaller facilities.

One theory put forward in the Nature story is that, due to restrictions on in-person appointments, health care providers may have missed developing conditions and potential problems. In addition, expectant parents, unsure of the rules around appointments and worried about the virus, may have delayed care or missed appointments.

On the flip side, the apparent drop in premature births may be due to the fact that mothers stuck at home are less stressed and more well-rested, and are less exposed to other germs and viruses.

COVID-19 and expectant mothers

It appears that the coronavirus itself might not be to blame. Several studies 1,2,3,4 have found similar health outcomes for infected and non-infected women. But the lack of access to care caused by pandemic-induced shutdowns may have had an effect.

Staying healthy

What can be done about it? As of mid-September, many U.S. states have lifted or started to lift restrictions. Expectant parents should stay in contact with their health care providers and bring them any and all concerns.


1. Trippella, G., Ciarcià, M., Ferrari, M., Buzzatti, C., Maccora, I., Azzari, C., Dani, C., Galli, L., & Chiappini, E. (2020). COVID-19 in Pregnant Women and Neonates: A Systematic Review of the Literature with Quality Assessment of the Studies. Pathogens (Basel, Switzerland) , 9 (6), 485. https://doi.org/10.3390/pathogens9060485

2. Hayakawa, S., Komine-Aizawa, S., & Mor, G. G. (2020). Covid-19 pandemic and pregnancy. The journal of obstetrics and gynaecology research , 10.1111/jog.14384. Advance online publication. https://doi.org/10.1111/jog.14384

3. Elshafeey, F., Magdi, R., Hindi, N., Elshebiny, M., Farrag, N., Mahdy, S., Sabbour, M., Gebril, S., Nasser, M., Kamel, M., Amir, A., Maher Emara, M., & Nabhan, A. (2020). A systematic scoping review of COVID-19 during pregnancy and childbirth. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics , 150 (1), 47–52. https://doi.org/10.1002/ijgo.13182

4. Yang, Z., Wang, M., Zhu, Z., & Liu, Y. (2020). Coronavirus disease 2019 (COVID-19) and pregnancy: a systematic review. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians , 1–4. Advance online publication. https://doi.org/10.1080/14767058.2020.1759541