Did you know 98% of stillbirths happen in low-income countries? Read the causes and global impact in this stillbirth statistics article.
Despite significant strides in prenatal care, stillbirth - defined as the loss of a baby at or after 20 weeks into pregnancy – is an all too frequently unacknowledged issue impacting maternal health.
It can occur independently of lifestyle and overall wellness status due to mysterious causes that remain elusive even among improved prenatal support.
Dr. Michael C. Lu, Former Director of the Maternal and Child Health Bureau at the Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services, stated:
"Stillbirth is a devastating event that affects about 1 in 160 pregnancies in the United States. It's crucial to understand that stillbirth can occur for many reasons, including placental problems, infections, and complications with the umbilical cord. However, the cause remains unknown in many cases, making it a deeply challenging experience for families."1
Medical Contributors to this Article
Key stillbirth statistics
- Each year, almost 2 million stillbirths occur worldwide - that's equivalent to 1 every 16 seconds. Over 40% of these heartbreaking losses happen during labour and delivery. However, with enhanced quality care, such as regular monitoring and quick access to emergency obstetric services when deemed necessary, many of these preventable deaths could be prevented.5
- The stillbirth rate remained highest among newborns of the Black ethnicity at 6.5 per 1,000 births as opposed to 3.5 for White infants and an Asian stillbirth rate of 4.7 per every thousand births.3
- Research has revealed that up to 25% of stillbirths may be avoidable, despite the belief held by numerous individuals - including some medical professionals - that they are unavoidable.6
- The Maternal and Fetal Health Research Centre has discovered that stillbirth could have a lasting, noticeable effect on the health of grieving parents. This may result in diminished well-being and poorer overall physical condition for them.10
- Global stillbirth rates have significantly decreased over the last 20 years, with a reduction of 35% from 21.3 stillbirths per 1,000 total births in 2000 to just 13.9 in the year 2021.7
The global prevalence and causes of stillbirths
Dr. Robert Silver, an expert in maternal-foetal medicine, has noted that despite significant advances in prenatal care, the prevalence of stillbirth has remained relatively unchanged, highlighting the complexity of its underlying causes.
He highlights that "stillbirth is a multifaceted issue with causes ranging from placental abnormalities and infections to maternal health conditions and lifestyle factors, many of which are not easily mitigated by current medical interventions." Dr. Silver emphasises the importance of ongoing research to understand better and address the diverse factors contributing to stillbirth rates.2
Although there have been improvements in prenatal care, the incidence of stillbirth has not significantly decreased. The factors that may contribute to it vary, taking into account maternal well-being concerns and choices related to lifestyle.
- The rate of stillbirth differs across various ethnic groups; for instance, the infant mortality rate in Bangladesh is 4.5 per 1,000 live births.4
- There are 4.3 Indian stillbirths per 1,000 people.4
- There are 5.1 stillbirths per 1,000 in Pakistan.4
- For every 1,000 births, there are 4.7 infants stillborn with an Asian background other than the primary one being discussed.4
- The rate of Black African stillbirths is 6.9 per 1,000.4
- The rate of Black Caribbean stillbirths is 4.6 per 1,000.4
- The rate of Black background among 1,000 births is 6.0, while it is 4 for other backgrounds.4
| Cause | Percentage |
|---|---|
| Unexplained | 50% |
| Congenital Anomaly | 16% |
| Placental Challenges | 9% |
| Maternal Illness | 6% |
| Death During Labor | 7.6% |
In England and Wales, the stillbirth rate per 1,000 births was higher in the top 10% most deprived areas at 5.0 and 6.3, respectively, compared to the bottom 10% least deprived areas where it measured lower with rates of only around a calculated figure of about 3.7 for England's results.3
These statistics are interesting, considering the regions and ethnic backgrounds of individuals who experience stillbirth.
Dr. Dirk Wallmeier, our chief medical advisor, says, "Younger women have adapted to societal expectations and have become more aware of mental health and its importance.
Among other factors such as access to healthcare, technological influences, and social and economic pressures younger women have learned to deal with mental health challenges better than older women, often seeking help."
The possibility of reducing the rate of stillbirth
Despite the number of global stillbirths, there haven’t been significant findings on preventative measures or treatment methods due to various factors and underlying health concerns. However, as technology progresses, there could be an easier way for early detection.
Dr. Dirk Wallmeier, our chief medical advisor, reiterated that despite experiencing a stillbirth, there are minimal to no chances of it reoccurring later down the line.
Women need to see their doctor early on in the pregnancy to maintain a healthy pregnancy and prevent any distressing outcomes.
- Research has revealed that up to 25% of stillbirths may be avoidable, despite the belief held by numerous individuals - including some medical professionals - that they are unavoidable.6
All cases were subjected to standardised evaluation comprising a maternal interview, medical record analysis, collection of biospecimens, and placental pathology with recommended clinical scrutiny alongside postmortem examinations. Based on this assessment framework, the initial Causes of Fetal Death System (INCODE) classified each event into probable or possible etiologies.
For statistical purposes, here we specified possibly preventable instances- non-anomalous infants weighed not less than ‘500g’, aged ≥24 weeks gestational age induced by causes such as intrapartum complications; hypertensive disorder arising during pregnancy; placenta insufficiency; multiple pregnancies except Twin-twin transfusion syndrome; spontaneous preterm birth or significant underlying condition/s.
Out of the 512 stillbirths analysed in the study, potential causes for preventable stillbirths included placental insufficiency (65 cases - 12.7%); medical complications during pregnancy (31 cases - 6.1%); hypertensive disorders originating from pregnancy (20 instances - 3.9%), preterm labour-related incidents concerning the delivery (16 occurrences - 3.1%), intrapartum linked factors caused by childbirth procedures or activities themselves which amounted up to approximately nine events or so contributing a percentage of close to about 1.8% and multiple gestations resulting in four faint possibilities amounting less than 1% each.6
- Global stillbirth rates have significantly decreased over the last 20 years, with a reduction of 35% from 21.3 stillbirths per 1,000 total births in 2000 to just 13.9 in the year 2021.7 The overall number of stillborn cases has also declined by an equal percentage- from approximately 3 million to roughly 2 million instances seen globally.
Nonetheless, these falling statistics haven't matched up well enough against other important markers, such as child mortality rate among those under five years old, and remain behind it till today's date.7
The Every Newborn Action Plan (ENAP) is an initiative that seeks to attain a stillbirth rate of 12 or less per every 1,000 births by 2030 and lessen gaps in equity among nations. Investment is crucial for quality antenatal and delivery care.
To achieve this target goal set out by ENAP, about 56 countries urgently need to expedite their progress efforts.
According to projections based on current standards worldwide, preventing almost all instances from occurring could save over 2.6 million unborn lives before reaching that same milestone date through an enhanced program outcome.
If high-income country benchmarks were met at 3 fatalities per 1,000, potentially 8.4 million deaths could be avoided altogether.7
If global healthcare improves across all factions, this will become a game-changer for the fertility industry. Not only will parents be able to care for their children beyond birth, but this drastically minimises the neonatal death rate.
In years to come, with constant technological innovations, there will be earlier detection methods for mother and baby.
Understanding the psychological impact of stillbirths among couples
Losing a child, regardless of the age, can be a lifetime traumatic experience for most. Understanding the risks and challenges and how to overcome them becomes essential when pursuing fertility options or trying to conceive children naturally.
- The Welsh Government's 2022 Maternity and Birth Statistics report reveals that during their initial assessment, pregnant women from Mixed ethnic groups (39%) and White backgrounds (33%) reported higher rates of mental health conditions compared to Black and Asian women who only reported a rate of 10%. This data elucidates considerable discrepancies in prenatal mental health reporting across diverse ethnicities.8
- In 2021, a comprehensive analysis was conducted to examine the prevalence of depression, anxiety and post-traumatic stress disorder (PTSD) in parents following stillbirth. The study consisted of 13 reports, revealing that parental reporting for all three psychological illnesses increased significantly among those who had suffered from stillborn births as compared to their counterparts with live childbirth experiences.9
- The Maternal and Fetal Health Research Centre has discovered that stillbirth could have a lasting, noticeable effect on the health of grieving parents. This may result in diminished well-being and poorer overall physical condition for them.10
Our chief medical advisor, Dr. Dirk Wallmeier, mentioned that during circumstances such as these, there are definitely long-term psychological effects.
A stillbirth followed by a pregnancy can be daunting for women, but regular checkups with a doctor will allow you to pick up any foreseeable problems.
To make your fertility journey easier, book a free consultation with us.
Frequently asked questions
What is a stillbirth?
Stillbirth and miscarriage are both types of pregnancy loss, but they differ in the timing of foetal death. Miscarriage occurs when the foetus dies before week 20, while stillbirth refers to a situation where foetal death happens after that point during pregnancy. 11
What are the different types of stillbirth?
Based on the duration of pregnancy before foetal death, healthcare providers categorise stillbirths as follows:
- Early foetal demise occurs when the foetus passes away between 20 to 27 weeks.
- A late stillbirth refers to foetal death occurring between 28 and 36 weeks of gestation.
- A stillbirth is the death of a foetus that occurs in or after the 37th week.11
What are the common causes of a stillbirth?
Up to 50% of stillbirths in developing countries are attributed to infections caused by viruses, parasites, bacteria, or other pathogens. In developed countries, these same types of infections cause up to 25% of stillbirth cases.11
How do you check if the foetus is still active?
Before labour, the majority of stillbirths occur. To locate the heartbeat of the foetus, your healthcare provider will utilise an ultrasound examination.11
What happens to the foetus in the event of a stillbirth?
Your healthcare provider will suggest the safest method of delivering the foetus, and you can expect an experience similar to delivering a live baby. Your team of pregnancy caregivers will offer guidance, support, and medication to alleviate any discomfort during delivery.
- Healthcare providers may advise initiating labour promptly following a stillbirth. If you have an underlying medical condition, induced labour might be more appropriate for your overall well-being. Typically, medication will kickstart contractions within 48 hours of the loss.
- Opting for a natural delivery allows you the option of delaying childbirth until up to two weeks after the foetus has been expelled. However, conducting an autopsy may pose challenges later on.
A C-section, or Caesarean section, may be necessary in emergencies where your health is in danger. However, it is uncommon for stillbirths to require a C-section.11
Sources
- Health Resources and Services Administration (HRSA)
- The National Center for Biotechnology Information (NCBI)
- Office for National Statistics (ONS)
- Office for National Statistics (ONS)
- World Health Organization (WHO)
- The National Center for Biotechnology Information (NCBI)
- UNICEF
- Welsh Government
- BioMed Central (BMC)
- Springer
- Cleveland Clinic
