New Global Report Answers 10 Questions on Stillbirth
During 2021, nearly 4 stillbirths occurred every minute, which amounts to over 5,000 babies who were born stillborn every day. These data points are included in a recently published second stillbirth report from the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). They are calculated from the most up-to-date data (and estimated projections in some cases where data is not available), from 195 countries, painting a picture of the current reality of late gestation stillbirth, or deaths that occur at 28 weeks or more of gestation. These data, presented in the report along with poignant personal anecdotes representing those who have directly experienced stillbirths, highlight the immense, continued annual burden and psychological stress of stillbirths.
The report includes brilliant, visual representation of the latest data in a ’10 things to know’ list. I summarize the list of 10 questions here.
10 Things to Know
1. How many babies are we losing to stillbirth every year?
In 2021, almost 1.9 million babies were stillbirth at 28 weeks or more of gestation.
2. Where are most stillbirths taking place?
Mothers in sub-Saharan Africa and Southern Asia suffered nearly 8 in 10 (77%) of the documented stillbirths taking place in 2021. Six countries (India, Pakistan, Nigeria, the Democratic Republic of the Congo, Ethiopia and Bangladesh) accounted for almost half of the estimated global number of stillbirths.
3. When do most stillbirths occur? Can stillbirths be prevented?
In 2021, more than 2 in 5 stillbirths that took place were intrapartum; in high-burden settings, this rises to 1 in 2 stillbirths. Most intrapartum stillbirths are preventable. In most cases, access to high-quality care, such as timely monitoring and interventions to address complications, will help prevent stillbirths.
4. What are the key causes of and risk factors for stillbirth?
The causes and risk factors for stillbirth include: access to health services, socio-economic determinants, environmental impacts, maternal fertility-related conditions, and behavioral factors. A recently published stillbirth conceptual framework maps out specific factors that can influence stillbirth outcomes.
5. How successful have we been in preventing stillbirths?
Both the global stillbirth rate and annual number of stillbirths have declined by about 35% since 2000, from 21.3 per 1,000 total births to 13.9 per 1,000. This is promising, but we still fall short of where we need to be to achieve the ENAP target for stillbirths (12 or fewer stillbirths per 1,000 total births by 2030) and the progress over the last decade has been slower than the previous decade.
6. Worldwide, are we making the same strides towards preventing stillbirths?
All regions have seen their stillbirth rates go down, but the degree of these reductions varies widely. The greatest declines from 2000 to 2021 were in Asia’s two regions, and sub-Saharan Africa has made the least progress and still has the highest stillbirth rate. Out of the 30 countries with the highest stillbirth rates, 80% are in sub-Saharan Africa.
7. How does progress in preventing stillbirths compare to success in preventing under-five deaths?
The stillbirth rate is declining more slowly (35%) than the under-five mortality rates (50%).
8. Without accelerated efforts to prevent stillbirths, what do projections show will happen between now and 2030?
If trends continue and further efforts are not made, 15.9 million babies will be stillborn between now and 2030. Nearly half of these deaths are expected to occur in sub-Saharan Africa. In this scenario, 56 countries will not achieve the ENAP target of 12 stillbirths or fewer per 1,000 total births by 2030.
9. How many lives could be saved if we strengthen our investments?
If all countries achieve the ENAP target by 2030, an estimated 2.6 million more babies will live. This is 30 more babies surviving every hour or 800 more babies surviving every single day!
10. What will it take to drive sustainable change and end preventable stillborn deaths?
The report lays out the following recommended action points for preventing stillborn deaths:
- Strengthen stillbirth data: Data systems must be strengthened and embedded into national routine HMIS to improve data availability and quality, particularly in low- and middle-income countries.
- Target setting: Local and national stillbirth targets need to be set in every country. We must have a target, and know our targets, in order to achieve change.
- Find ways to decrease the stigma: A world that recognizes that most stillbirths are preventable and where stillbirth is discussed openly without shame or blame.
- Support: Compassionate and respectful support is needed for every bereaved woman and family.
- High-quality care: A health care system that provides high-quality care to every mother and child.
- Investment: Achieve equity in every country and region through sustained investment.
Millions of families around the world have had lives changed forever by the trauma of losing a baby to stillbirth. Let us not forget the stories of these families and babies, and use this moment to ramp up our efforts to prevent stillbirth. Additionally, the causes of stillbirths are inseparable from those that kill pregnant women and newborns, thus investments to reduce stillbirths would bring a quadruple return by reducing stillbirths, neonatal deaths, maternal deaths and maternal and neonatal morbidity.
There is a feasible path to decrease stillbirths – these changes ARE possible, but the changes require the spark of political will and sustained efforts to realize them.
*Read more about stillbirth by accessing AlignMNH’s curated collection around stillbirth.
Amy Cannon, RN, MPH, is a Maternal and Newborn Health Technical Advisor at Jhpiego.