Stillbirths must be part of the conversation on newborn health
Each October 15th, the world marks Pregnancy and Infant Loss Remembrance Day, a moment to honor lives lost and renew our commitment to ending preventable deaths. The day also reminds us of an often-overlooked truth: stillbirths remain a large yet hidden component of the global burden of child mortality.
Stillbirths account for an estimated 26 percent of global under-five deaths; a staggering figure rarely mentioned because stillborn babies are typically excluded from how we count and talk about under-five deaths. Yet, babies who die before they take their first breath are newborns just as much as babies who breathe after birth. Both must be included when we speak of newborn survival and health.
Global Maternal and Child Deaths 2021
Annual Global Maternal and Child Deaths
| Type of death | Count | Year | Definition | Data source |
|---|---|---|---|---|
| Maternal deaths | 287,000 | 2020 | https://data.unicef.org/topic/maternal-health/maternal-mortality/ | |
| Under-5 child deaths other than newborns | 2,666,322 | 2021 | (<5 deaths*) – (deaths of liveborn newborns) | calculated by Excel formula |
| Deaths of liveborn newborns | 2,360,922 | 2021 | 0 days to 1 month | https://childmortality.org/all-cause-mortality/data/estimates?indicator=TMM0&refArea=WORLD |
| Deaths of stillborn newborns | 1,884,935 | 2021 | 28+ weeks’ gestation | https://childmortality.org/all-cause-mortality/data/estimates?indicator=SB&refArea=WORLD |
| TOTAL | 7,199,179 |
Not only is the sheer burden of stillbirth enormous, but the inequities surrounding stillbirth are profound. UNICEF’s Never Forgotten: The situation of stillbirth around the globe report underscored the many stark inequities in stillbirths. For example, the stillbirth rate (SBR) in sub-Saharan Africa and South Asia is approximately 12 times higher than in regions of the world with higher income countries. Behind these inequities lies a chronic lack of data: enormous gaps in tracking stillbirths, in measuring the quality of care, and in understanding how stigma and structural inequities drive risk. The Ending Preventable Stillbirths Global Scorecard, developed by the Stillbirth Advocacy Working Group of the International Stillbirth Alliance, sheds light on progress and stagnation, and also highlights the many gray areas where data simply do not exist. Lack of data hampers advocacy and policy work; for instance, there are no regularly reported data on subnational stillbirth disparities, nor on measuring stigma.
Research investment tells a similar story. An analysis by the MARCH Centre of the LSHTM in The Lancet Global Health revealed stunning disparity: while hundreds of millions of dollars are directed toward newborn health research, funding for stillbirth prevention is several orders of magnitude lower, at just a few million. This neglect is not an accident of accounting; it reflects unheard voices and invisible losses.
Why has progress been so slow? Stillbirth was absent from the Millennium Development Goals, and it remains absent in the Sustainable Development Goals (SDGs). Most national reporting frameworks mirror that omission, with just 31% of 106 countries setting their own SBR targets as of 2022 [paper reporting this has been submitted for publication; these data are the latest from UNICEF EWENE reporting]. As we look to a post-SDG era, we must not repeat that mistake. Stillbirths should be counted, studied, funded, and prevented with the same urgency and compassion as every other adverse maternal and newborn outcome.
This October, we have an obligation to honor the millions of babies who are stillborn each year around the world by demolishing the myth of stillbirth’s inevitability and insisting on the full incorporation of stillbirths within post-2030 global health agendas, platforms, and tracking. Stillborn babies ARE newborn babies.
In memory of Wilder Daniel Leisher, stillborn at 38 ½ weeks on July 13, 1999, with no cause found.
About the author:
Dr. Susannah (Zan) Hopkins Leisher is the Co-Director of the University of Utah Stillbirth Center of Excellence, the Ex-Officio Chair of the International Stillbirth Alliance, and a Steering Committee Member for AlignMNH.