Call to Action: Ending Preventable Stillbirths
The Lancet Ending Preventable Stillbirths Series includes five articles written by over 210 authors from 43 different countries. The research in this series shows that about 2.6 million babies are stillborn every year and highlights the huge impact this loss of life has on families, care-givers, societies and governments.
Sadly, most of these deaths could be prevented with better care for women during pregnancy and birth. This series builds on the Lancet Stillbirths Series published in 2011. By reviewing where progress has and has not been made since 2011, this series shows what should be done to end preventable stillbirths by 2030 (which is the year by which countries around the world have committed to improve health for mothers and babies).
Frances Day-Stirk, ICM President has welcomed the Call to Action and renewed global push to end preventable stillbirths saying, "The ICM has long recognised that stillbirth care is integral to quality pregnancy and labour care. This issue sits at the heart of the role of the midwife, therefore ICM promotes the education of midwives to global competencies and standards so that women receive quality care from competent midwives. The Lancet Series Ending preventable stillbirth is a welcome and vitally important document for parents, professionals and policy makers as we enter the 2030 era."
What has changed since 2011 and what needs to change in future?
We need to speed up work to reduce stillbirth. There were 18.4 stillbirths per 1000 total births worldwide in 2015, compared to 24.7 in 2000. On average, the stillbirth rate has fallen by 2% per year, but this reduction is slower than for deaths of pregnant women (which fell by 3% in the same time period) or the deaths of children younger than 5 years (which fell by 4.5%). In 2014, the World Health Assembly, which decides policies for the World Health Organisation (a United Nations organization focused on global health) agreed to a target of 12 or fewer stillbirths per 1000 births in every country by 2030. By 2015, only 94 countries, mainly high income and middle income countries, had reached this target. At least 56 countries, particularly in Africa and countries affected by war, will have to at least double their present rate of progress to reach this target. Countries, particularly those which have a stillbirth rate less than 12 per 1000 births, were also asked to set and meet targets to close gaps in stillbirth rates between different groups of women (such as those suffering racial and social disadvantage). The series calls for all countries to honour these commitments.
Stillbirth needs to be included in national and global policies and programmes. Strong leadership is needed worldwide and in individual countries to co-ordinate and lead local, national, and global efforts for mothers and their babies. Considering how huge the impact of stillbirth is, it is surprising that not much money has been given to research and implementation programmes aiming to prevent stillbirth and improve care after a stillbirth. It is also important that more research into stillbirth prevention and bereavement care is carried out.
For countries to make progress, they need to make the changes that are called for in global plans in ways that suit their own situation. Collection of information about stillbirths needs to improve, because this will help us to understand how well countries are doing to stop stillbirths. All births, stillbirths, deaths of mothers and deaths of newborns must be officially counted, and the stillbirth rate during pregnancy (“antepartum stillbirth rate”) and during birth (“intrapartum stillbirth rate”) should be measured every year in each country. To help understand stillbirths better, all countries should agree to use one system to identify the causes of stillbirth; at the moment there are too many different systems in use, and none are working well.
Call to Action
Similar to the call for action in the 2011 stillbirth series, this Series also calls for action to end preventable stillbirths. The implementation of global strategies such as the “Sustainable Development Goals” and the “Global Strategy for Women’s, Children’s, and Adolescents’ Health” (the global plan to help implement the health-related Sustainable Development Goals) will be easier if stillbirths are treated just like any other death and are counted. By making sure all women are given good quality care during pregnancy and childbirth in the 75 countries with the worst stillbirth rates, we could prevent 823,000 stillbirths, 1,145,000 newborn deaths and 166,000 deaths of pregnant women every year by 2030, at an additional cost of US$2,143 or £1,436 for each life saved.
Read more from the Stillbirth Alliance
Read The Lancet Ending Preventable Stillbirths Series