‘€œEach year over two million babies and mothers die at birth. The huge numbers hide multiple personal stories of loss. Each death is a tragedy to a family ‘€“ actually, a double tragedy since almost all these deaths could be prevented,’€ says Dr Joy Lawn of Saving Newborn Lives/Save the Children USA. The more than 1-million stillbirths are also not currently recorded in the Millennium Development Goals (MDG) or the Global Burden of Disease figures.

Speaking at the 14th FIGO (International Federation of Gynecology & Obstetrics) World Congress of Gynecology and Obstetrics yesterday (SUBS: TUESDAY), Lawn revealed that in most sub-Saharan African countries, and many other poor countries, birth is the time when the risk of death is the greatest.

A seven paper supplement published in the International Journal of Gynecology & Obstetrics and released at the FIGO conference is an effort to present evidence for action to reduce the huge toll of deaths at the time of birth.

Researchers were at pains to point out that it wasn’€™t ‘€œa competition’€, but they did share data showing that the 904 000 babies who died each year due to childbirth complications outnumbered child deaths due to malaria and HIV/AIDS. Yet, so far these baby deaths have received far less attention and investment.

Reducing these deaths is crucial if countries had any hope of reaching MDG 4 and 5 – both aimed at reducing maternal and child deaths.

The goal of MDG 5 is to reduce maternal mortality by 75% by 2015, however little or no progress has been made towards achieving this goal, with over 500 women dying every year due to pregnancy and delivery related complication ‘€“ the equivalent of three Jumbo Jets filled with pregnant women crashing every day.

‘€œWe have no choice but to improve the care at birth if we have any hope of reaching MDG 5,’€ said Lawn.

Professor Rob Pattinson of the University of Pretoria and one of the authors, presented data which showed that thousands of deaths of babies could be prevented at South Africa’€™s health institutions, specifically at district hospital level where most of the avoidable deaths occurred.

Their research showed that the care provided to mothers and babies during birth was poor and despite an audit and feedback at 34 hospitals nothing had changed over a five year period.

One of the key challenges in trying to turn the tide worldwide will be to reach the more than 60-million women who give birth at home every year.

The research papers present various simple and viable interventions that could save hundreds of thousands of lives. Studies are showing that money for transport, lack of transport, long distances and socio-cultural issues are the main barriers stopping women from giving birth at health facilities with skilled attendants. Clear solutions include reducing delays in reaching care, community mobilisation, task shifting (entrusting professional care to skilled mid-level workers) and effective care at the time of birth.

The Bill & Melinda Gates Foundations has funded several studies and programmes which are looking at either finding ways to move families closer to the facilities in the run-up to the birth or bringing the health system closer to the pregnant women.

All these interventions have shown significant reductions in early neonatal mortality and maternal mortality rates. Studies are also showing that most of the babies born at home or in poorly resourced health facilities need either simple newborn care of basic neonatal resuscitation to survive.

Dr Gary Darmstadt of the Gates Foundation points out that the supplement is the first major attempt to bring attention to a problem that has largely gone unnoticed due to a lack of proper information.

‘€œThere is growing recognition that the time has come to change the situation where these deaths are being neglected. These interventions could also be used quite effectively to strengthen health systems,’€ says Darmstadt.

‘€œUnless more priority is given, the world with continue to miss the unheard cry of the 250 babies who die every hour from childbirth complications,’€ the authors said in joint a statement.

A United Nations summit earlier this year saw the first major global investment of U$5,3-billion with the explicit priority of improving care at birth.

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