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Stillbirth, especially unpredicted losses in the antepartum period defined as intrauterine fetal demise after twenty weeks gestation, remains sadly a too common event during pregnancy. Dr. Gandhi and Professor Reddy detail the epidemiology and review the impact of proactive interventions both in preparation for and during pregnancy to lower stillbirth rates. The clinical management of a pregnancy affected by this tragedy. The authors address a growing understanding of causes seen clinically and those unseen (e.g. genetic abnormalities, viral infection, fetal hypoxia in a normally grown fetus, etc). The detailed approach to stillbirth during the index pregnancy seeks to maximize the discovery of the underlying causes to provide solace to the grieving family and to prepare for any additions to prenatal care for any subsequent pregnancies.