Where, When, Why And What is the Cost to Women, Families and Societies?

Session: End Preventable Stillbirths: Identify, Prevent, Treat, and Care

Presenter: Hannah Blencowe, London School of Hygiene & Tropical Medicine
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Background: Stillbirths were not tracked under the Millennium Development Goals, and progress in reducing stillbirths is slower than that for maternal or neonatal deaths, despite at least half of stillbirths being preventable with achievable care. The costs and implications of stillbirth for parents, families, care providers and communities are under-appreciated.

Methodology: We review data for stillbirths worldwide to map progress towards the 2030 national stillbirth rate (SBR) target of 12 or fewer stillbirths per 1000 births and to identify data priorities for action. We summarise previous research on the economic and psychosocial costs of stillbirth and present an overview of new analyses regarding these costs, highlighting the need for investment.

Results: Progress is being made towards ending preventable stillbirths, however marked disparities remain between and within countries. New data searches contributing to the forthcoming WHO stillbirth estimates show that SBR data have increased, yet data on timing of stillbirth (intrapartum vs antepartum) remains limited. Many conditions associated with stillbirth are modifiable including maternal age, infections, non-communicable diseases and nutrition and life-style factors. The indirect, emotional and psychological harm of stillbirth are far-reaching, considerable, and usually met by families, particularly in lower resource settings. The impact of stillbirth is magnified by societal norms which may stigmatise women.

Conclusion: Worldwide, several million third trimester stillbirths occur each year, 75% in Sub-Saharan Africa and South Asia. Stillbirths are increasingly being counted, however absence of reporting mechanisms using standard definitions continue to limit their visibility. Action is still required to improve the data gathering systems for stillbirths, particularly in countries with the greatest burden. Most stillbirths are preventable, yet these losses weigh heavily on families, healthcare and society. The forthcoming Lancet Series on Ending Preventable Stillbirths will provide data for action to accelerate change for the thousands of women experiencing stillbirth every day.