Topping the wrong chart: India has highest number of stillbirths

India recorded 0.34 million stillbirths in 2019; COVID-19 has disrupted health systems and added to the existing burden

By Kiran Pandey
Published: Friday 09 October 2020

Some 0.34 million of the 1.9 million stillbirths globally in 2019 were in India, making it the country with the largest such burden, according to the first joint estimates released by a number of United Nations agencies October 8, 2020.

India, along with five other countries — Pakistan, Nigeria, the Democratic Republic of the Congo, China and Ethiopia — accounted for nearly half of all stillbirths in the world, according to the report.

A stillbirth means a baby born with no signs of life at 28 weeks of pregnancy or more, according to UN agencies.

The country had made substantial progress in reducing the stillbirth rate over the past two decades. The rate had declined to 13.9 stillbirths per 1,000 births in 2019, from 29.6 in 2000 — a 53 per cent reduction. Globally, a 35 per cent reduction in stillbirth rate was recorded in this period.

However, progress had been slow, the report noted. India’s progress in reducing the stillbirth rate improved marginally by 2.7 percentage points in the 2010s, compared to the 2000s.

In comparison, global progress in reducing the stillbirth rate did not improve over the 2010s compared to the 2000s.

The novel coronavirus disease (COVID-19) pandemic could increase the global number of stillbirths, including in India, the report flagged.

Stillbirths have not declined as rapidly as maternal and newborn mortality, despite progress being made since 2000. If current trends continue, an additional 19 million stillbirths will take place before 2030. This would result in an immense and unjust strain on women, families and society.

In fact, more than 200,000 stillbirths would be recorded over the next 12 months in 117 low- and middle-income countries due to severe COVID-related disruptions in health care services.

The estimates are based on a study by the Johns Hopkins Bloomberg School of Public Health.

Why the rise 

At least eight prenatal checkups, one ultrasound before 24 weeks of pregnancy and a daily intake of iron and folic acid supplements are required to prevent a stillbirth, according to the World Health Organization (WHO).

However, pregnant women faced reduced mobility and inability to access health care due to the lockdown, the report said.

Health personnel, especially maternity health workers and midwives in hospital and community settings, were overburdened due to COVID. This affected the availability of essential maternal and newborn services to mothers and children.

COVID-19 had also disrupted the critical supply chains for essential medicine and equipment, affecting the ability of the health care workers to ensure adequate and quality care.

Overall, very few women were receiving timely and high-quality care to prevent stillbirths even before the pandemic began, the report pointed out, citing a Lancet study. The disrupted health systems post-pandemic added to the crisis that already existed. 

The UNICEF, WHO, the World Bank Group and the Population Division of the United Nations Department of Economic and Social Affairs were among the agencies who produced the report. 

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