New Lancet Special Series Puts Unprecedented Focus on Impact and Prevention of Stillbirth, a Devastating but Undercounted and Understudied Loss

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WESTPORT, Conn. (April 14, 2011) — More than 2.6 million women experience stillbirth every year, according to the most systematic review to date of stillbirth around the world, published today in a special issue of The Lancet medical journal. Save the Children led the new estimates for the special series, which drew on the efforts of 69 authors from 18 countries and more than 50 organizations.

The Lancet Series on Stillbirths includes groundbreaking analysis of this invisible and undercounted tragedy affecting women and families around the world. Save the Children, which authored the only previously published estimates of stillbirths, this time collaborated with the World Health Organization (WHO) and other researchers to develop a comprehensive set of stillbirth estimates for 193 countries, including time trends for 2005-2009. The numbers will for the first time be included in WHO’s annual World Health Statistics report due to be released in May 2011.

“Almost no burden affecting families is so big and yet so invisible in society and on the global public health agenda. Yet this invisible loss deeply affects women all over the world. The new information published today documents their hidden grief as well as the social stigma these women often endure,” said Joy Lawn, Director of Global Evidence and Policy for Save the Children’s Saving Newborn Lives program, coordinator of the new stillbirth estimates and a lead author of The Lancet’s Series on Stillbirths.

The new stillbirth estimates would be even higher than 2.6 million under broader definitions used in most high-income countries. The Lancet authors used the WHO international definition, which classifies stillbirth as the loss of pregnancy after the 28th week. In the United States, for instance, stillbirth is defined as loss of pregnancy after 20 weeks.

The new findings in The Lancet Series on Stillbirths include:

  • 98 percent of stillbirths occur in low- and middle-income countries.
  • Half of all stillbirths occur in just 5 countries — India, Pakistan, Nigeria, China and Bangladesh.
  • Pakistan has the highest rate of stillbirths — nearly 47 per 1,000 births.
  • Two-thirds of stillbirths occur in rural areas, where trained and skilled midwives are scarce.
  • Worldwide, the rate of stillbirths has dropped by only 1.1 percent each year since 1995 — much slower progress than for maternal and child deaths.
  • Finland and Singapore have the lowest stillbirth rate — 2 stillbirths per 1,000 births.
  • The U.S. has a rate of 3 stillbirths per 1,000 births using the WHO definition, or 5 per 1,000 using the US definition. This is higher than 16 other developed countries.
  • In high-income countries, the rate of decline in stillbirths has stagnated and 1 in 320 pregnancies end in stillbirth.

The Lancet special series highlights the major causes of stillbirths as: childbirth complications, maternal infections in pregnancy, maternal disorders, fetal growth restriction and congenital abnormalities. Almost half of all stillbirths (1.2 million a year) occur during labor and delivery.

Globally, 3.6 million newborn deaths and 350,000 maternal deaths occur each year. Public health interventions such as emergency obstetric care and treatment of maternal infections and conditions prevent most of these deaths, and also could avert 1.1 million stillbirths if made universally (99 percent) available in countries with the highest burden of stillbirths, according to the new analysis in The Lancet. In total 2.7 million deaths of mothers and newborns and stillbirths could be prevented, at only an additional cost of US$2.32 per person.

Said Lawn: “Now that we have reliable data on stillbirths and consensus on how to prevent them, we must act. The positive news is that the same basic services proven to reduce maternal and newborn deaths could prevent over a million stillbirths worldwide each year. It is now clearer than ever that these services — especially care at birth — have a triple return on investment. Counting the stillbirths is added value for families and for health programs.”

Save the Children joins more than 50 other organizations, including the World Health Organization, and the International Stillbirth Alliance in a global call to action to reach all families with basic maternal and newborn care, to reduce stillbirth rates to less than 5 per 1000 births in low and middle income countries, and to eliminate all preventable stillbirths in high-income countries, by 2020.

Save the Children is the leading, independent organization that creates lasting change for children in need in the United States and around the world. Follow us on Twitter and Facebook.

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