One stillbirth occurs every 16 seconds, according to first ever joint UN estimates
The vast majority of stillbirths, 84 per cent, occur in low- and lower-middle-income countries, according to the new report, A Neglected Tragedy: The Global Burden of Stillbirths. In 2019, 3 in 4 stillbirths occurred in sub-Saharan Africa or Southern Asia. A stillbirth is defined in the report as a baby born with no signs of life at 28 weeks of pregnancy or more, the WHO’s official website reads.
«Losing a child at birth or during pregnancy is a devastating tragedy for a family, one that is often endured quietly, yet all too frequently, around the world,» said Henrietta Fore, UNICEF Executive Director. «Every 16 seconds, a mother somewhere will suffer the unspeakable tragedy of stillbirth. Beyond the loss of life, the psychological and financial costs for women, families and societies are severe and long lasting. For many of these mothers, it simply didn’t have to be this way. A majority of stillbirths could have been prevented with high quality monitoring, proper antenatal care and a skilled birth attendant.»
The report warns that the COVID-19 pandemic could worsen the global number of stillbirths. A 50 per cent reduction in health services due to the pandemic could cause nearly 200 000 additional stillbirths over a 12-month period in 117 low- and middle-income countries. This corresponds to an increase in the number of stillbirths by 11.1 per cent. According to modeling done for the report by researchers from the Johns Hopkins Bloomberg School of Public Health, 13 countries could see a 20 per cent increase or more in the number of stillbirths over a 12-month period.
Most stillbirths are due to poor quality of care during pregnancy and birth. Lack of investments in antenatal and intrapartum services and in strengthening the nursing and midwifery workforce are key challenges, the report says.
Over 40 per cent of stillbirths occur during labour—a loss that could be avoided with access to a trained health worker at childbirth and timely emergency obstetric care. Around half of stillbirths in sub-Saharan Africa and Central and Southern Asia occur during labour, compared to 6 per cent in Europe, Northern America, Australia and New Zealand.
Even before the pandemic caused critical disruptions in health services, few women in low- and middle-income countries received timely and high-quality care to prevent stillbirths. Half of the 117 countries analyzed in the report have coverage that ranges from a low of less than 2 per cent to a high of only 50 per cent for 8 important maternal health interventions such as C-section, malaria prevention, management of hypertension in pregnancy and syphilis detection and treatment. Coverage for assisted vaginal delivery - a critical intervention for preventing stillbirths during labour – is estimated to reach less than half of pregnant women who need it.
As a result, despite advances in health services to prevent or treat causes of child death, progress in lowering the stillbirth rate has been slow. From 2000 to 2019, the annual rate of reduction in the stillbirth rate was just 2.3 per cent, compared to a 2.9 per cent reduction in neonatal mortality, and 4.3 per cent in mortality among children aged 1–59 months. Progress, however, is possible with sound policy, programmes and investment.
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