Despite the fact that the majority of stillbirths are preventable, very little progress has been made to bring down the number of stillbirths. In the past 15 years maternal and child deaths have halved, while 2.6 million stillbirths continue to occur every year – a number much too high to be accepted.
This “silent” problem – stillbirths (in the third trimester of pregnancy) – has been studied in a new series by The Lancet. Not only does the Ending Preventable Stillbirth Research Series shed light on global reduction rates and risk factors of stillbirths, but it highlights the neglected psychological, social and economic impacts of stillbirth on women and communities. New evidence shows that at least 4.2 million women are living with the effects of stillbirth – suffering from depression, stigma, social isolation, as well as an increased risk of violence and abuse.
“We must give a voice to the mothers of 7,200 babies stillborn around the world every day. There is a common misperception that many of the deaths are inevitable, but our research shows most stillbirths are preventable.”
– Professor Joy Lawn, London School of Hygiene & Tropical Medicine
Women in the most disadvantaged communities are at a much higher risk of stillbirth. Yet, progress to decrease the stillbirth rate remains slow in high-income countries too, where the number of stillbirths is often higher than infant deaths. Globally, the annual rate of reduction for stillbirths is 2.0%, which is much slower than the progress that is being made for maternal (3.0%) and child deaths (4.5%). Nearly all stillbirths – 98% of them – occur in low- and middle-income countries.
Half of all stillbirths take place during labor and birth, usually when a pregnancy is in full term, and research shows that most of these 1.3 million deaths are preventable with improved quality of care. The first global analysis of risk factors associated with stillbirth is included in the new series – showing how deaths can be prevented. The research shows that the most effective methods to reduce stillbirths include: treating infections during pregnancy (Malaria and Syphilis in particular), tackling obesity and non-communicable diseases (diabetes and hypertension foremost), ensuring access to quality family planning services – especially for older women and girls, who face a higher risk of stillbirth, and reducing inequalities.
Evidence shows that prevention is possible.
The Netherlands is making the fastest progress, with an annual reduction rate of 6.8%. The United States is one of the countries making the least amount of progress, with a reduction of 0.4% per year. Rwanda is outperforming its neighbours with an annual rate of reduction of 2.9% – making it the fastest progressing country in Africa and showing that change is achievable everywhere in the world.
The Lancet’s Ending Preventable Stillbirths Series includes five papers developed by 216 experts from over 100 organizations. This series presents compelling evidence that most stillbirths are preventable, providing a platform for action by politicians, health care professionals, parents and pregnant women themselves.
Let’s make sure that ending preventable stillbirths does not only get on the agenda of maternal and newborn health, but that necessary action is taken and enough resources are allocated to this issue for there to be real, lasting impact and change.
Featured photo credit: Hien Macline / United Nations Photo (Creative Commons on Flickr).