Almost 2 million babies are stillborn every year – or one every 16 seconds, says the first-ever stillbirth report by the United Nations Inter-Agency Group for Child Mortality Estimation (UN-IGME).
The vast majority of stillbirths or 84% occur in low and lower-middle-income countries, according to the new report titled “A Neglected Tragedy: The Global Burden of Stillbirths”.
The report was conducted in collaboration with the United Nations Children's Fund (UNICEF), World Health Organisation (WHO), the World Bank Group and the Population Division of the United Nations Department of Economic and Social Affairs (EC-ESA).
In 2019, three in four stillbirths occurred in sub-Saharan Africa or Southern Asia.
The study defines stillbirth as a baby born with no signs of life at 28 weeks of pregnancy or more.
The study also warns that COVID-19-related health service disruptions could worsen the situation.
“A 50% 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%.”
UNICEF Executive Director, Henrietta Fore, has described losing a child at birth or during pregnancy as one of the devastating tragedies, a family could ever face.
"One that is often endured quietly, yet all too frequently, around the world,” Fore said.
“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.”
Fore believes a majority of stillbirths could have been prevented with high-quality monitoring, proper antenatal care and a skilled birth attendant.
The Johns Hopkins Bloomberg School of Public Health’s modelling predicts that 13 countries could see a 20% increase or more of stillbirths over a 12-month period.
Poor quality of care.
Most stillbirths are attributed to poor quality of care during pregnancy and birth, the study found.
Also, the lack of investments in antenatal and intrapartum services and in strengthening the nursing and midwifery workforce are key challenges.
Over 40% of stillbirths occur during labour, which could be avoided with access to a trained health worker at childbirth and timely emergency obstetric care, the report added.
“Around half of the stillbirths in sub-Saharan Africa and Central and Southern Asia occur during labour, compared to 6% 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.”
Progress, however, is possible with sound policy, programmes and investment.
"Welcoming a baby into the world should be a time of great joy, but every day thousands of parents experience unbearable sadness because their babies are stillborn,” said WHO Director-General, Dr Tedros Adhanom Ghebreyesus.
Investing in healthcare.
“The tragedy of stillbirth shows how vital it is to reinforce and maintain essential health services, and how critical it is to increase investment in nurses and midwives.”
The report also noted that stillbirth is not only a challenge for poor countries.
In 2019, 39 high-income countries had a higher number of stillbirths than neonatal deaths and 15 countries had a higher number of stillbirths than infant deaths.
In both low and high-income settings, stillbirth rates are higher in rural areas than in urban areas, while socioeconomic status is also linked to a greater incidence of stillbirth.
Ethnic minorities in high-income countries, in particular, may lack access to enough quality health care.
“The report cites that Inuit populations in Canada, for example, have been observed to have stillbirth rates nearly three times higher than the rest of Canada and African American women in the United States of America have nearly twice the risk of stillbirth compared to white women,“ it noted.