Maternal and Child Health Journal

, Volume 17, Issue 10, pp 1835–1841 | Cite as

Hospital Costs Associated with Stillbirth Delivery



Fetal deaths account for nearly one percent of all births in the United States. The cost of hospital care associated with fetal deaths may be substantial. However, there is very limited data on the economic burden of fetal death. We conducted a retrospective medical chart review of stillbirths at three large hospitals in Michigan over a ten-year period and identified medical complications, hospital costs, and length of stay for these deliveries. Mothers with stillbirth were matched with mothers of the same age who delivered a live-born infant at the same hospital during the same year. Our final sample was comprised of 533 stillbirths and 1,053 matched live births. Average hospital cost for stillbirth was $7,495 (±7,015) and the average length of stay was 2.8 days (±2.8). Having a serious maternal medical complication was associated with higher costs and longer length of stay among women with stillbirth. Early stillbirths between 20 and 28 weeks gestational age, epidural/spinal/general anesthesia, and cesarean delivery were also associated with longer length of stay. Average hospital costs for women with stillbirth were more than $750 higher than women with live births but length of stay was not significantly different between the two. This study suggests that stillbirths were associated with substantial maternal hospital costs. Future research examining the economic impact of stillbirths beyond labor and delivery such as increased costs associated with additional testing and care in subsequent pregnancies will help better understand the overall economic impact of stillbirths.


Fetal death Hospital costs Length of stay Obstetrics Stillbirth 



Salary support for the first author came from the Robert Wood Johnson Clinical Scholars Program, and the National Institutes of Health (K-12, K23). Additional project support was provided by Angel Names Association. No funder had a role in design and conduct of the study, analysis, preparation of results, or approval of the manuscript.

Conflict of interest

None of the authors has any financial or other conflict of interest to declare.


  1. 1.
    Macdorman, M. F., & Kirmeyer, S. (2009). The challenge of fetal mortality. NCHS Data Brief, 16, 1–8.PubMedGoogle Scholar
  2. 2.
    Xu, X., et al. (2009). Cost of racial disparity in preterm birth: Evidence from Michigan. Journal of Health Care for the Poor and Underserved, 20(3), 729–747.PubMedCrossRefGoogle Scholar
  3. 3.
    Elixhauser, A., & Wier, L. (2011). Complicating conditions of pregnancy and childbirth, 2008. Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
  4. 4.
    Russo, C., Wier, L., & Steiner, C. (2009). Hospitalizations related to childbirth 2006. Rockville, MD: U.S. Agency for Healthcare Research and Quality.Google Scholar
  5. 5.
    Thomson Healthcare. (2007). The healthcare costs of having a baby. Report for the March of Dimes. Accessed 1 Dec 2012.
  6. 6.
    United States Centers for Medicare & Medicaid Services, Historical Impact Files. Accessed 11 Nov 2012.
  7. 7.
    United States Department of Labor Bureau of Labor Statistics, Consumer Price Index Medical Care Services. Accessed 11 Nov 2012.
  8. 8.
    American College of Obstetricians and Gynecologists. (2009). ACOG Practice Bulletin No. 102: Management of stillbirth. Obstetrics and Gynecology, 113(3), 748–761.Google Scholar
  9. 9.
    Bukowski, R., et al. (2011). Causes of death among stillbirths. The Journal of the American Medical Association, 306(22), 2459–2468.CrossRefGoogle Scholar
  10. 10.
    Froen, J. F., et al. (2009). Making stillbirths count, making numbers talk—Issues in data collection for stillbirths. BMC Pregnancy Childbirth, 9, 58.PubMedCrossRefGoogle Scholar
  11. 11.
    Kuklina, E. V., et al. (2009). Severe obstetric morbidity in the United States: 1998–2005. Obstetrics and Gynecology, 113(2 Pt 1), 293–299.PubMedGoogle Scholar
  12. 12.
    Radestad, I., et al. (1998). A comparison of women’s memories of care during pregnancy, labour and delivery after stillbirth or live birth. Midwifery, 14(2), 111–117.PubMedCrossRefGoogle Scholar
  13. 13.
    Weeks, J. W. (2008). Antepartum testing for women with previous stillbirth. Seminars in Perinatology, 32(4), 301–306.PubMedCrossRefGoogle Scholar
  14. 14.
    Scifres, C. M., & Macones, G. A. (2008). Antenatal testing—Benefits and costs. Seminars in Perinatology, 32(4), 318–321.PubMedCrossRefGoogle Scholar
  15. 15.
    Gold, K. J. (2007). Navigating care after a baby dies: A systematic review of parent experiences with health providers. Journal of Perinatology, 27(4), 230–237.PubMedCrossRefGoogle Scholar
  16. 16.
    Boyle, F. (1997). Mothers bereaved by stillbirth, neonatal death or sudden infant death syndrome: Patterns of distress and recovery. Aldershot: Ashgate.Google Scholar
  17. 17.
    Vance, J. C., et al. (2002). Couple distress after sudden infant or perinatal death: A 30-month follow up. Journal of Paediatrics and Child Health, 38(4), 368–372.PubMedCrossRefGoogle Scholar
  18. 18.
    Osterweis, M. (1984). Reactions to particular types of bereavement. In M. Osterweis, F. Solomon, & M. Green (Eds.), Bereavement: Reactions, consequences, and care. Washington, DC: Institute of Medicine, National Academy Press.Google Scholar
  19. 19.
    Boyle, F. M., et al. (1996). The mental health impact of stillbirth, neonatal death or SIDS: Prevalence and patterns of distress among mothers. Social Science and Medicine, 43(8), 1273–1282.PubMedCrossRefGoogle Scholar
  20. 20.
    Fuchs, V. R., & Perreault, L. (1986). Expenditures for reproduction-related health care. The Journal of the American Medical Association, 255(1), 76–81.CrossRefGoogle Scholar
  21. 21.
    Stillbirth Collaborative Research Network Writing, G., et al. (2011). Causes of death among stillbirths. The Journal of the American Medical Association, 306(22), 2459–2468.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.Department of Family MedicineUniversity of MichiganAnn ArborUSA
  2. 2.Department of Obstetrics and GynecologyUniversity of MichiganAnn ArborUSA
  3. 3.Department of BiostatisticsUniversity of MichiganAnn ArborUSA
  4. 4.Department of Obstetrics, Gynecology and Reproductive SciencesYale UniversityNew HavenUSA

Personalised recommendations