Undercounting of Stillbirths in India

April 24, 2026

Susan Chacko

An analysis of National Family Health Survey (NFHS) data reveals a significant undercounting of stillbirths in India. The data suggests that this issue is particularly prevalent for stillbirths occurring before 28 weeks of gestation.

Stillbirths occurring before 28 weeks of gestation are not captured in routine surveys, contributing to systematic underestimation and missed opportunities for targeted interventions, the study said.The World Health Organization (WHO) definition for international reporting of stillbirths is foetal death at more than or equal to 28 completed weeks’ gestation or a birth weight greater than or equal to 1,000 g if gestational age is unknown.The study used 3 rounds of NFHS data (2005-06, 2015-16 and 2019-21) for burden, trend analysis of stillbirths.

Data from 2019-21 was used for risk factor assessment. The researchers calculated the stillbirth rate (SBR) at more than equal to 28, 24 and 20 weeks of gestation.The researchers from Mahidol University in Thailand reported that approximately 40 per cent of total stillbirths occur between more than equal to 20 weeks and less than equal to 28 weeks of gestation. This means that by considering only stillbirths occurring at more than equal to 28 weeks of gestation (in line with global standard for comparison), approximately two-fifths of total stillbirths are being excluded.

Analysis of 542,359 women from three survey rounds showed SBR of 12.8, 16.2, and 22 per 1,000 total births at more than or equal to 28, 24, and 20 weeks of gestation, respectively.Trend analysis revealed that the SBR during 2019-21 was 11.7 per 1,000 total births at more than equal to 28 weeks’ gestation, compared to 12.4 and 19.4 per 1,000 in 2005-06 and 2015-16, respectively.Additionally, it was observed that approximately 40 per cent (42.5 per cent during 2019-21, 42.4 per cent during 2015-16 and 41.3 per cent during 2005-06) of all stillbirths in India are between 20 and 28 weeks of gestation.