PMNCH Fact sheet: Stillbirths

Updated September 2011

  • Some 2.6 million third trimester stillbirths worldwide occur every year, according to the first comprehensive set of stillbirth estimates, published today within a special series in the medical journal The Lancet.
  • Every day more than 7,300 babies are stillborn. A death occurs just when parents expect to welcome a new life.
  • Ninety-eight percent of stillbirths occur in low and middle-income countries. Wealthier nations are not immune with 1 in 200 pregnancies resulting in a stillbirth - two thirds occurring in the last trimester of pregnancy, a rate that has stagnated in the last decade.
  • The five main causes of stillbirths are childbirth complications, maternal infections in pregnancy, maternal disorders (especially pre-eclampsia and diabetes), fetal growth restriction and congenital abnormalities.
  • The number of stillbirths worldwide has declined by only 1.1 percent per year, from 3 million per year in 1995 to 2.6 million in 2009. This is slower than reductions for child and maternal mortality.
  • Before-labour stillbirths account for 1.4 million deaths.
  • Almost half of stillbirths, 1.2 million, happen when the woman is in labor. These deaths are directly related to the lack of skilled care at this critical time for mothers and babies.
  • If all causes of stillbirth are taken together, the new estimates would place stillbirths fifth on the list of causes of deaths worldwide, according to The Lancet’s Stillbirths Series, authored by 69 experts from more than 50 organizations in 18 countries. The Series is comprised of six scientific papers, two research articles, and eight linked comments.

Where do stillbirths occur?

  • An African woman has a 24 times higher chance of having a stillbirth at the time of delivery than a woman in a high-income country.
  • Two-thirds of stillbirths happen in rural areas, where skilled birth attendants, in particular midwives and physicians, are not always available for essential care during childbirth and for obstetric emergencies, including caesarean sections.
  • The stillbirth rate varies sharply by country, from the lowest rates of 2 per 1,000 births in Finland and Singapore and 2.2 per 1,000 births in Denmark and Norway, to highs of 47 in Pakistan and 42 in Nigeria, 36 in Bangladesh, and 34 in Djibouti and Senegal.
  • It is estimated that some 1.8 million stillbirths occur in ten countries — India, Pakistan, Nigeria, China, Bangladesh, Democratic Republic of the Congo, Ethiopia, Indonesia, Afghanistan and United Republic of Tanzania. Half of all stillbirths occur in India, Pakistan, Nigeria, China and Bangladesh alone. These same countries account for a high number of maternal and newborn deaths.
  • Rates also vary widely within countries. In India, rates range from 20 to 66 per 1,000 births in different states. In high-income countries, disadvantaged women still have very high stillbirth rates. For example, indigenous women in Canada and Australia have stillbirth rates equal to women living in some low and middle-income countries.
  • Comparing 1995 to 2009 stillbirth rates, the smallest declines were reported in Sub-Saharan Africa and Oceania. Significant declines are reported for China, Bangladesh, and India, which had a combined estimate of 400,000 fewer stillbirths in 2009 than in 1995.
  • Stillbirth rates have halved in China and Mexico since 1995.

Well-known interventions for women and babies would also reduce stillbirths

Well-known interventions for women and babies would also reduce stillbirths. “This Series shows that the way to address the problem of stillbirth is to strengthen existing maternal, newborn, and child health programs by focusing on key interventions, which often overlap with those interventions that benefit mothers and neonates,” says Gary L. Darmstadt, M.D., Director, Family Health Division, Global Health Program, Bill & Melinda Gates Foundation.

Source : Lancet Stillbirth release April 2011