Each year, more than 2.6 million stillbirths occur worldwide - more than 7,300 each day. Most of these deaths are preventable, yet stillbirths have been overlooked as a global public health crisis. As a result of social taboos, political neglect and health system and data gaps, millions of stillbirths go unreported each year. Stillbirths are not included in worldwide health targets and, until now, data for stillbirth rate were not routinely collected or collated by UN agencies.
Where do stillbirths happen? 98% of stillbirths occur in low- and middle-income countries, and 55% in rural families in sub-Saharan Africa and south Asia. An estimated 1.8 million stillbirths, 2/3 of the total burden, happen in just 10 countries - the same countries where 2/3 of newborn deaths and over 60% of maternal deaths occur. Stillbirths also continue to affect high-income countries, where around 1 in every 320 babies is stillborn. Around 1.2 million stillbirths - nearly 45% of the global burden - occur during labour and birth.
What can be done? Well-known cost-effective interventions for women and newborns save stillbirths too. Researchers have reviewed 35 potential interventions, and outline 10 key interventions that, if packaged properly, introduced widely, and implemented in the 68 Countdown countries, could prevent as many as 200,000 maternal deaths, 1.5 million newborn deaths, and 1.1 million stillbirths by 2015. Childbirth care, particularly emergency obstetric care, reduces the highest number of stillbirths, and should be the first priority.
Stillbirths should no longer be one of the most neglected areas of public health. This is a moment when the huge, hidden tragedy of stillbirth has the best chance to date of moving from the shadows towards more attention and action on the global stage. The extensive analysis presented in the Lancet Series suggests the annual burden could be cut in half by 2015.
What can our community can do?
> Know and use the information, get the word out:
Browse the full list of resources, news articles, open-access research studies, blogs from authors and experts, and multimedia content - all available free for download (below). New! The Stillbirths Lancet Series is now available as an eBook -- free to download directly to your mobile handheld device.
Key messages - The Lancet papers and executive summary include headline messages that summarize key information. PMNCH's Stillbirth Knowledge Summary synthesizes the evidence in a short, user-friendly format to inform policy and practice.
Know your data - Available for 193 countries, stillbirth rates, numbers, progress from 1995-2009 and national rankings. Access the Excel spreadsheet here.
Create a National Factsheet - A short summary (1-2 pages) highlighting your national numbers, rates, rankings and key issues to address. See this example from South Africa, and model yours after this factsheet. Share it with key partners including professional and UN agencies.
Organize events - A great way to spread the word. Invite media, professional partners and parents to discuss what your community or country can do to prevent stillbirth and to better support families. Reach out to parents who have experienced a loss, give them a voice. The International Stillbirth Alliance connects parents with existing support services.
Maximise the data - Download and use the free software, Lives Saved Tool (LiST), to estimate how many stillbirths, maternal and neonatal deaths could be prevented with key interventions.
You can break the silence
Born in Silence tells the powerful story of stillbirth from the parents perspective. Stillbirth is a difficult topic. People often don't know what to say when a friend or family member has a stillbirth. Health care workers may not be trained in caring for those parents. The hope is that this video will begin to break the silence around stillbirth.
Save the Children's Dr Joy Lawn talks about the under reported tragedy of stillbirth and describes how you can use these key resources to help break the silence and create change for mothers, newborns and stillbirths. > Join us.
Stillbirth refers to a baby born with no signs of life at or after 28 weeks (6 months) of pregnancy. The five most common causes of stillbirth are similar to those that also kill mothers and newborns - most of which can be prevented or treated with care provided by a trained health worker.
- Childbirth complications;
- Maternal infections during pregnancy;
- Maternal conditions, especially hypertension and diabetes;
- Fetal growth restriction; and
- Congenital abnormalities
The Lancet Series on Stillbirths is a landmark publication, presenting in detail the causes and global burden of stillbirths, providing a framework to deliver solutions within the context of reproductive, maternal and child health, and nutrition programs, along with a rallying cry for collective action.
Reducing the burden by 2020
To achieve a substantial reduction in stillbirths, maternal, and neonatal mortality, concerted action is needed by many - including coutnry, regional, and local governments, WHO and other international health organizations, foundations, research institutions, and professional and non-governmental organizations.
Goals for low- and middle-income countries:
> Reduce stillbirth by at least 50% by 2020
Goals for all high-income countries:
> Reduce third-trimester stillbirth rates to less than 5 per 1000 births by 2020
> Close equity gaps
> Eliminate all preventable stillbirths
A series of steps to be taken at the international, country, and community levels to achieve these goals by 2020 or earlier are outlined in the closing paper of the Lancet series.