Behind the Silence of Stillbirth

A stillbirth is the death of a baby within a pregnant body after twenty weeks of pregnancy. According to the World Health Organisation (WHO) 2.6 million stillbirths occurred in 2015. Those living in the Global South are the most at risk, but in countries around the world the numbers remain too high – 15 babies each day are stillborn or die within a month of birth in the UK, with black and Asian babies being the most at risk, and in 46% of these cases the causes are unknown.

This being said, this phenomenon is still very rarely talked about, and so the grief and suffering of many victims goes unnoticed. I think it’s important to raise awareness, to encourage others not to idealise pregnancy, to highlight the importance of protecting one’s body and mind and to support each other in these painful but ‘part-of-life’ moments.

I am a French Afro-descendant woman living in Berlin where I have been entitled to care and support from the moment I discovered I was pregnant to the funeral of my baby girl. The pro-natalist policies in Germany gave me the choice to keep my child and to plan accordingly. I have had monthly ultrasound scans, extra vitamins, and an incredible community of mothers and expecting mothers to answer my many questions and provide me with mental support. However, even in the best conditions, my baby died inside my womb for unknown reasons except the fact that life is not – as pregnancy is not – a straight forward process.

I have been amazed to see that sharing my personal story has enabled other women to openly talk about their experiences. However, I have also faced insensitive comments and people asking me or other women without a child for the reason of their child’s death. I often wondering about the intention behind these kinds of comments, although I am sure they cannot be intended to help the suffering mothers feel more at peace.

Grieving mothers have to navigate between hormonal changes, body (re)transformation and loss of identity. Victims are often unable to bear the extra pain that comes from others’ inability to deal with the loss, including family and friends. It is important to find a good balance between support and space to let the victim heal in her very personal way from the loss of a part of herself.

Women react in different ways to stillbirth but many feel they have violently lost a part of themselves in the process. Being pregnant can be a traumatic experience – talking from my personal experience, throwing up and being exhausted is a difficult adventure. Worse than the extreme body transformation of pregnancy, though, is the need to deliver a breathless baby’s body. It took me weeks to understand that my daughter was not within me anymore. A grieving mother isn’t just a woman after losing her baby. She is a broken women, and she needs time to heal.

My relatives have been extremely affected by the loss of this child and have been incredibly supportive. They have included YunNan, my first child, in our family. She is daughter, a niece, a granddaughter, and a great-granddaughter, and she alwasy will be.

There is nothing to be ashamed of in losing a child. It is essential to tell women who have experienced stillbirth that they are victims, to tell our blinded society that stillbirth occurs more than we think, and to tell those who want to help that there ways for them bring about positive change for grieving parents.

The number of stillbirths declined by only 19% between 2000 and 2015. Ignoring stillbirth is an issue that leads to shocked, grieving parents and incomprehension among wider society, and so society at large must change. Stillbirth is part of a bigger picture framed by sexism, racism and classism. It is our duty to all, women and men included, to care for each other, to collaborate and to strive together to break the silence that surrounds stillbirth. 

The featured image of this post was drawn by my brother in honour and memory of YunNan, my stillbirth baby girl.

Stillbirths – A neglected global epidemic reports The Lancet

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).