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Vast Majority of Stillbirths Found in Developing Countries

Aline Cunico

UNITED NATIONS, Apr 14 2011 (IPS) - According to a special series in the medical journal The Lancet presented in New York Wednesday at the U.N. children’s agency UNICEF, over 2.6 million stillbirths occur worldwide annually, affecting mostly African and Asian women who lack proper access to health care and facilities.

“We need to be more aware,” Dr. Ruth Fretts, a stillbirth expert and assistant professor at Harvard Medical School, told IPS. “We need to review all stillbirths systematically so that we can develop strategies for prevention. Stillbirths are a great burden to women, and are life- changing events.”

Fretts added that lack of awareness and health access, affecting mostly pregnant women in developing countries, hamper attempts to reduce stillbirth – the death of a baby at 28 weeks’ gestation or more – and in many cases, causing maternal deaths.

“Developing countries in general have limited resources for the care of women and 27 percent of stillbirths occur in labour. Improved antenatal [care], proper access to antibiotics and timely caesarean section could make a significant reduction in stillbirths,” she said. According to the series, women from low and middle-income countries are 24 times more likely to have a stillbirth at the time of delivery than women in high-income countries. The five main causes of stillbirths are childbirth complications, maternal infections in pregnancy, maternal disorders, fetal growth restriction and congenital abnormalities – most of which could be prevented by empowering women around the world with the right interventions.

Most cases 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.

Over 1.8 million stillbirths occur every year in India, Pakistan, Nigeria, China, Bangladesh, Democratic Republic of Congo, Ethiopia, Indonesia, Afghanistan and Tanzania.

The Lancet series urged the need for greater public awareness, noting that despite the high numbers, addressing stillbirths is not included in the Millennium Development Goals (MDGs) for maternal and child health set by the United Nations.

“Stillbirths often go unrecorded, and are not seen as a major public health problem,” said Dr. Flavia Bustreo, assistant director-general for Family and Community Health at the World Health Organization. “Yet stillbirth is a heartbreaking loss for women and families. We need to acknowledge these losses and do everything we can to prevent them.”

More aid needed

Another report by the Center for Global Development (CGD), released here Tuesday, reinforces the importance of family planning in developing countries.

An estimated 215 million women lack access to modern contraceptives, causing 75 million unplanned pregnancies every year worldwide.

The report says that maternal and child health have received increased attention in recent years, but states that sexual and reproductive health should be a main priority in developing countries, in order to achieve all the other MDGs.

“One of the biggest issues in achieving the Millennium Development Goals is the high unmet needs on family planning. There is a big demand for information and services for reproductive health, including family planning, most especially for the poorest of the poor,” Benjamin Deleon, president of the Forum for Family and Development, told IPS.

According to the report, little has been done for women in Africa, the Middle East and South Asia since the landmark International Conference on Population and Development in Cairo in 1994.

For example, there are approximately 350,000 maternal deaths each year, most of which could be prevented.

“Maternal health should be the concern of all, particularly the governments from the least developed countries and intermediate countries that are struggling to meet maternal health in the context of MDGs. The international community should provide resources for this purpose. Indeed, no woman should die giving life,” concluded Deleon.

The CGD report urged the U.N. Population Fund, which is facing flat or reduced funding, to take a clear lead on issues of population, sexuality, health, and women’s empowerment.

“UNFPA should focus on its core mission: expanding access to sexual and reproductive health and reproductive rights for women around the world,” said a statement by Rachel Nugent, CGD deputy director of global health and co-chair of the working group that prepared the report.

“Executive Director [Babatunde] Osotimehin can lead the way in preventing thousands of maternal deaths and millions of unwanted pregnancies worldwide each year,” she added.