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  • Dot-Mom

    New Global Health & Gender Policy Brief: The Global Burden of Stillbirths

    June 14, 2023 By Maternal Health Initiative Staff
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    In 2021, 1.9 million stillbirths occurred globally. A baby who dies at or after 28 weeks of pregnancy,* and is born with no sign of life is classified as a stillbirth. Stillbirths can be caused by pregnancy and childbirth-related complications, like hemorrhage, placental abruption, and pre-eclampsia; maternal infections during pregnancy, including malaria and sexually transmitted infections; prolonged pregnancy to 42 weeks or more; and pre-existing health conditions. Other risk factors include maternal age and smoking during pregnancy.

    While the rates of stillbirth have reduced since 35 percent since 2000, it pales in comparison to other significant strides made in preventing newborn and child death. For example, under five mortality rates declined by 50% in the same period. Without intervention, 15.9 million babies will be stillborn between now and 2030.  Increased research and political attention to stillbirths offers an opportunity to accelerate progress and reduce this number.

    In a new policy brief, The Global Burden of Stillbirths, the Wilson Center’s Maternal Health Initiative lays out the multi-faceted impacts of stillbirth on community, individuals, and society, and offers recommendations for increasing attention and action in preventing stillbirths and creating healthy and supportive environments for families who have experienced stillbirth.

    The Global Burden of Stillb… by The Wilson Center

    Stillbirth is a global health issue that affects millions of families each year–but the impacts aren’t equally distributed. The country with the highest stillbirth rate has a rate 20 times higher than the country with the lowest rate. Data from 2021 shows stillbirths concentrated in Sub-Saharan Africa (45%) and Central and Southern Asia (33%). The stillbirth rate in Sub-Saharan Africa was 21 per 1000 total births, compared to just 2.9 in Europe, Northern America, Australia, and New Zealand. The current global target is 12 or fewer stillbirths per 1,000 total births in every country by 2030.

    The risk of stillbirth is also highest in humanitarian settings – 51 percent of stillbirths occur in the 29 countries with 2023 UN Humanitarian Appeals. The ongoing impacts of climate change also play a role in stillbirth rates globally, as studies have found links between extreme heat and air pollution and increased stillbirth risk. While the full scope of the effect of COVID-19 on stillbirth is still being measured, studies in the United States found that women with COVID-19 at the time of delivery had a higher risk of delivering a stillborn baby compared to women without COVID-19.

    Global initiatives to address stillbirth include the Every Newborn Action Plan (ENAP), the United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME), and the International Stillbirth Alliance (ISA). These organizations work to set national and global standards for stillbirth rates, to improve data collection and analysis, and to improve health care and community support for parents experiencing stillbirth.

    In order to achieve global progress in reducing rates of stillbirth, this brief provides the following policy recommendations:

    1. Increase data on stillbirths to decrease prevalence.
    2. Reduce the stigma, taboo, and misconception of stillbirth.
    3. Set national and local stillbirth reduction targets.
    4. Invest in strengthening health systems to provide high-quality care, particularly in humanitarian settings and regions with the highest prevalence of stillbirths.
    5. Enact supportive policies for working parents who experience loss.

    * Definitions of stillbirth vary globally. The definition from the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) is a baby born with no sign of life at 28 weeks of pregnancy or later. Other definitions include a baby born with no sign of life as early as 20- or 24-weeks’ gestation.

    This brief was made possible through the generous support of EMD Serono, the healthcare business of Merck KGaA, Darmstadt, Germany.

    Sources: Centers for Disease Control and Prevention, Environment International, Inter-Agency Working Group on Reproductive Health in Crises, International Stillbirth Alliance, UNICEF, United Nations Inter-Agency Group for Child Mortality Estimation, World Health Organization.

    Photo Credit: Hands holding a newborn baby’s head. Photo courtesy of Jlhinton/flickr.

    Topics: Dot-Mom, family planning, gender, global health, health systems, humanitarian, maternal health, newborn and child health, Stillbirth

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