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[afro-nets] 2.6 million babies stillborn in 2009: Lancet Series

News release: WHO/5

12 April 2011  

2.6 million babies stillborn in 2009

New global and country estimates published in Lancet Series

Geneva, 14 April 2011: Some 2.6 million stillbirths occurred worldwide in 2009, 
according to the first comprehensive set of estimates published today in a 
special series of The Lancet medical journal.

Every day more than 7 200 babies are stillborn ─ a death just when parents 
expect to welcome a new life ─ and 98% of them occur in low- and middle-income 
countries.  High-income countries are not immune, with one in 320 babies 
stillborn ─ a rate that has changed little in the past decade.

The new estimates show that the number of stillbirths worldwide has declined by 
only 1.1% per year, from 3 million in 1995 to 2.6 million in 2009.  This is 
even slower than reductions for both maternal and child mortality in the same 

The five main causes of stillbirth are childbirth complications, maternal 
infections in pregnancy, maternal disorders (especially hypertension and 
diabetes), fetal growth restriction and congenital abnormalities.

When and where do stillbirths occur?

Almost half of all stillbirths, 1.2 million, happen when the woman is in 
labour.  These deaths are directly related to the lack of skilled care at this 
critical time for mothers and babies.

Two-thirds 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 

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.  Rates also vary widely within countries.  In India, 
for example, rates range from 20 to 66 per 1 000 births in different states.

It is estimated that 66% ─ some 1.8 million stillbirths ─ occur in just 10 
countries: India, Pakistan, Nigeria, China, Bangladesh, Democratic Republic of 
the Congo, Ethiopia, Indonesia, Afghanistan and the United Republic of Tanzania.

Comparing stillbirth rates in 1995 to 2009, the least progress has been seen in 
Sub-Saharan Africa and Oceania.  However, some large countries have made 
progress, such as China, Bangladesh, and India, with a combined estimate of 400 
000 fewer stillbirths in 2009 than in 1995.  Mexico has halved its rate of 
stillbirths in that time.

Many stillbirths are invisible because they go unrecorded, and are not seen as 
a major public health problem.  Yet, it is a heartbreaking loss for women and 
families.  We need to acknowledge these losses and do everything we can to 
prevent them.  Stillbirths need to be part of the maternal, newborn and child 
health agenda,” says Dr Flavia Bustreo, WHO's Assistant Director-General for 
Family and Community Health.

Well-known interventions for women and babies would save stillbirths too

The Series shows that the way to address the problem of stillbirth is to 
strengthen existing maternal, newborn, and child health programmes by focusing 
on key interventions, which also have benefits for mothers and newborns.

According to an analysis to which WHO contributed in The Lancet Stillbirth 
Series, as many as 1.1 million stillbirths could be averted with universal 
coverage of the following interventions:

   - Comprehensive emergency obstetric care           696 000
   - Syphilis detection and treatment                           136 000
   - Detection and management of fetal growth restriction           107 000
   - Detection and management of hypertension during pregnancy   57 000
   - Identification and induction for mothers with >41 weeks gestation          
 52 000
   - Malaria prevention, including bednets and drugs           35 000
   - Folic acid fortification before conception                   27 000
   - Detection and management of diabetes in pregnancy           24 000

Strengthening family planning services would also save lives by reducing the 
numbers of unintended pregnancies, especially among high-risk women, and 
thereby reduce stillbirths.

�If every woman had access to a skilled birth attendant a midwife, and if 
necessary a physician for both essential care and for procedures such as 
emergency caesarean sections, we would see a dramatic decrease in the number of 
stillbirths�,� says Dr Carole Presern, Director of The Partnership for 
Maternal, Newborn & Child Health (PMNCH), and a trained midwife.

Stillbirths overlooked

Despite the large numbers, stillbirths have been relatively overlooked. They 
are not included in the Millennium Development Goals for improving maternal 
health and reducing child mortality.

The estimates were generated using a statistical model that took records of 
births and deaths (known as 'vital registration' data) from 79 countries, 
surveys from 39 countries, and studies from 42 countries.  Weak vital 
registration systems, especially in the regions where most stillbirths occur, 
limit the availability of data and hamper the calculation of precise estimates. 
 Vital registration systems must be improved so that all stillbirths are 

The new estimates aim to improve knowledge about the extent of the problem, and 
draw public and professional attention to stillbirths as a significant global 
public health issue.

Some 69 authors from more than 50 organizations in 18 countries wrote the six 
scientific papers, two research articles, and eight linked commentaries 
included in The Lancet Stillbirth Series, which was initiated by the World 
Health Organization ( WHO) and the Norwegian Institute of Public Health.

UN commitment

In September 2010, UN Secretary-General Ban Ki-moon announced the Global 
trategy for Women�s and Children�s Health, aimed at saving 16 million women and 
children over the next five years.  In the framework of the Strategy, numerous 
countries have committed to improving access to family planning, antenatal care 
and skilled birth attendants, which should lead to reductions in stillbirths.

In September this year, a special session on noncommunicable diseases (NCDs) 
will be held at the UN General Assembly.  NCDs such as diabetes and 
hypertension (high blood pressure) are risk factors for stillbirth.

For further information

Embargoed materials (press release, map, b-roll, etc) are available from this 
password-protected web site:

Username: StillbirthEstimates
Password: 50%by2020

To arrange interviews, please contact:

Olivia Lawe-Davies, Department of Maternal, Newborn, Child and Adolescent 
Health, WHO <>; Office: + 41 22 
791 1209; Mobile: +41 79 475 5545

Tammy Farrell, Partnership for Maternal, Newborn & Child Health (PMNCH) <>; Office: + 41 22 791 4711

All WHO information can be found

Shila Kaur

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