Lancet Series Responds to the 2.6 Million Stillbirths Occurring Each Year

Today, The Lancet launched a new series on stillbirths.  In six series papers, two research articles, and eight comments, global health experts illustrate how stillbirths have been rendered invisible in the global health arena, and what can be done to bring these tragedies to light.  Through new analysis of stillbirth occurrences, success stories and lessons learned from around the world, with a focus on the poor and marginalized, The Lancet Stillbirth Series is a call to action that we cannot afford to ignore.

An Invisible Tragedy

New evidence suggests that stillbirths are the fifth most-common cause of death worldwide.  Previously, documenting the exact number of stillbirths had been difficult as the UN system did not collect data on these deaths.   In society, stillbirths are rarely mourned publically, particularly in low-income countries. 

Despite this widespread neglect, at least 2.6 million third-trimester stillbirths occur each year, 98% of them in low-income and middle-income countries. African women are 24 times more likely to have a stillbirth at the time of delivery than a woman in a developed country.  Rural women are particularly vulnerable as well, with two-thirds of stillbirths occurring in rural settings where skilled birth attendants are not readily available.  

Ten countries account for 66% of stillbirths worldwide:

1.    India
2.    Pakistan
3.    Nigeria
4.    China
5.    Bangladesh
6.    Democratic Republic of Congo
7.    Ethiopia
8.    Indonesia
9.    Tanzania
10.    Afghanistan

The top five causes of stillbirths are closely related to the top killers of mothers and newborns:

1.    Childbirth complications
2.    Maternal infections in pregnancy
3.    Maternal disorders, especially hypertension and diabetes
4.    Fetal growth restriction
5.    Congenital abnormalities

What needs to be done?

The number of stillbirths worldwide has only declined by 1.1% per year from 1995 to 2006.  “Stillbirths often go unrecorded, and are not seen as a major public health problem,” says Flavia Bustreo, M.D., Assistant Director-General for Family and Community Health at the World Health Organization. “Yet, stillbirth is a heartbreaking loss for women and families.  We need to acknowledge these losses and do everything we can to prevent them.”

There is hope in the success stories of China and Mexico, where interventions resulted in stillbirth rates decreasing by 50% since 1995.  In examining these countries and other success stories around the world, experts have found the following interventions as critical to decreasing stillbirths:

In total, these interventions could avert up to 1.1 million stillbirths.  According to Dr. Zulfiqar Bhutta, an additional 1.6 million mothers and newborn lives could be saved if five additional interventions were added, including antenatal steroids and neonatal resuscitation.  Averting stillborn deaths is within our reach.  “By shining a spotlight on the tragic toll of stillbirths, we can prevent stigma, relieve suffering and make greater progress to improve the health of every woman and every newborn,” says Purnima Mane, Deputy Executive Director of United Nations Population Fund.

The full Lancet Stillbirth Series is available here.