The National Center for Health Statistics (NCHS) has adopted a new, broader definition of perinatal mortality — deaths that occur around the time of birth. Until now, perinatal mortality included fetal deaths at 28 weeks of pregnancy or later and infant deaths within the first 7 days. The new definition lowers the threshold to include fetal deaths starting at 20 weeks.
Under the previous definition (called Definition I), only about 61% of all perinatal deaths were captured. The new definition (Definition III) includes more than 90%.
This change doesn’t mean more babies are dying — it means more of those deaths are now counted. As a result, reported perinatal mortality rates will be higher, not because of a worsening trend, but because the data is more complete.
All states now report fetal deaths starting at 20 weeks or more, which makes this expanded measure possible. Trends over time — and differences by race, age, or location — remain similar across both definitions, though the raw numbers are higher with the new one.
What it means for journalists
Perinatal mortality is a critical measure of the quality of prenatal, labor and delivery, and early neonatal care. The new standard provides a more accurate reflection of clinical outcomes and the lived experiences of families.
For example, in 2022, Definition III identified 30,506 perinatal deaths — accounting for 91.4% of all such deaths — compared to only 60.7% under the old definition. The reported mortality rate jumped from 5.51 to 8.27 per 1,000 births.
These aren’t just statistics — they represent real families and communities experiencing loss.
But, proceed with caution when using this data. Comparing numbers across years or between states using different definitions can lead to misleading conclusions. Going forward, using Definition III ensures consistency and clarity.
The updated measure also allows for deeper reporting on disparities. For example, in 2022, Black mothers had a perinatal mortality rate of 15.05 per 1,000 births under Definition III — more than twice the rate of white mothers. Native Hawaiian or Pacific Islander women also experienced disproportionately high rates. Including earlier fetal deaths helps paint a fuller, more accurate picture of racial and ethnic disparities in pregnancy outcomes.
Geographic patterns have shifted as well. While some states maintained similar rankings under both definitions, others saw dramatic changes. For example, Florida and Hawaii appeared among the 10 states with the highest perinatal mortality rates under Definition III — but not under the previous one.
This raises important questions for local accountability: Are these higher rates due to actual risk, or are they uncovering past underreporting or inconsistent classification? It’s essential to provide context — and to be clear about which definition is being used — when covering perinatal mortality trends.
