I recently published an article in the British Medical Journal (BMJ), “Stillbirth should be given greater priority on the global health agenda.” This article began as something I was writing on my own, but I quickly realized that many people are passionate about raising the profile of this preventable tragedy. I assembled a team of global experts to put together a case for stillbirth advocacy that was both persuasive and in line with all the latest objective data. The team includes bioethicists, practicing doctors, academics, and policymakers.
The three most important messages that resulted were:
- The burden of stillbirth is hidden.
- This is an issue affecting women, particularly the poor.
- The majority of cases are entirely preventable.
Less than five percent of global stillbirths are officially registered, compared to two-thirds of all live births(1).
Women, particularly in rural areas of developing countries, can have a stillbirth with no medical professionals around, and ?therefore no record of that baby entering or leaving the world. If we don’t have stillbirths being counted, then it is incredibly difficult for there to be targeted interventions to reduce them.
Fundamental to women’s reproductive rights is supporting wanted pregnancies, minimizing harm to mother and baby during pregnancy and childbirth, and ensuring survival and care of newborns. Many wanted pregnancies end in stillbirth, and the psychological effects on parents such as anxiety, depression, and post-traumatic stress can last a lifetime. What is more worrying is that such effects, both in high-income and low-income settings, are not fully socially recognized, leaving women feeling extremely unsupported at a very difficult time. Beyond the psychological issues, women affected by stillbirth are more likely to encounter medical complications that ultimately increase suffering and death, particularly during delivery and after birth. The women affected are disproportionately those in the poorest countries, and disproportionately those in the poorest sectors of high-income countries like the USA.
We know how to prevent stillbirths. If a woman went into labor with a live baby who then didn’t survive to delivery, it would be considered so outrageous in high-income countries that legal action would be considered. Yet 1.2 million stillbirths occur like this every year – a number that rises to 2.6 million if you include all stillbirths. The solution is simple, and hinges on good care during pregnancy and delivery. We have the evidence; what we need now is action.
One of the most powerful things that has come out of the BMJ publication is the outpouring of support I’ve been sent for being an advocate for reducing preventable stillbirths. I have been contacted by the media, doctors, researchers, and civil society groups. Perhaps even more powerful is the individual story of mothers. One woman contacted me simply saying “I appreciate it so much. Knowing that people out there are passionate about advancing this issue is so validating to me as a mom of a stillborn son.” She is an example of the women we are advocating for and the women we want to unsilence.