Health services disrupted by Covid-19 pandemic could lead to 200,000 stillbirths global, says study

Stillbirths Covid-19
There are nearly two million stillbirths around the world each year. (Amit Gaur)

Every 16 seconds, mothers around the world suffer what many call an unspeakable tragedy—stillbirth.

For the first time, experts around the world quantified the frequency of stillbirths. They now fear that the Covid-19 pandemic could increase this number.

Almost 2 million babies are listed as stillborn every year or one ever 16 seconds, according to new estimates. A Neglected Tragedy: The Global Burden of Stillbirths is a report that aims to address the global data gap around stillbirths. The study is a joint undertaking by the United Nations Children’s Fund (Unicef), the World Health Organisation (WHO), the World Bank and the Population Division of the United Nations Department of Economic and Social Affairs. 

“Every 16 seconds, a mother somewhere will suffer the unspeakable tragedy of stillbirth,” said Unicef Executive Director, Henrietta Fore. “Beyond the loss of life, the psychological and financial costs for women, families, and societies are severe and long-lasting. For many of these mothers, it simply didn’t have to be this way. A majority of stillbirths could have been prevented with high-quality monitoring, proper antenatal care and a skilled birth attended.”

A stillbirth is defined by the WHO as a baby born with no signs of life at or after 28 weeks of gestation.

An unequal burden

The report found that stillbirths are an unequal burden. It found that 84% occur in low and lower-middle-income countries. Three in four stillbirths occurred in sub-Saharan Africa and Southern Asia in 2019. The study indicates these numbers could worsen leading to 200,000 more stillbirths annually.

Six countries, nearly all of which are in the global south, accounted for half of the world’s stillbirths. The highest stillbirths are found in India, followed by Pakistan, Nigeria, the Democratic Republic of the Congo, China and Ethiopia.

The Covid-19 pandemic has disrupted health services around the world. The report’s authors warn a 50% reduction in health services could worsen healthcare for pregnant women in 117 countries.

“Covid-19 has triggered a devastating secondary health crisis for women, children, and adolescents due to disruptions in life-saving health services,” Muhammad Ali Pate, the World Bank’s Health, Nutrition and Population Director.

Pregnant women need constant access to quality care throughout their pregnancy and during childbirth, added Pate.

“We are supporting countries in strengthening their health systems to prevent stillbirths and ensure that every pregnant woman can access quality health care services,” he said.

Researchers at the Johns Hopkins Bloomberg School of Public Health reported that thirteen countries could see a 20% increase or more in the number of stillbirths over a 12-months period. They also found that most stillbirths are linked to poor quality of care during pregnancy and birth.

Other key challenges include the lack of investment in antenatal and intra-partum services. Researchers also identified difficulties in improving the nursing and midwifery workforce.

The Situation in South Africa

In the last year South Africa recorded 59,960 stillbirths. The Department of Home Affairs registered 1 051 311 live births in 2019. Still, but the Department of Health was upbeat about the overall data and the country’s handling of stillbirths, even with the Covid-19 pandemic.

“We don’t anticipate an increase in future due to aggressive measures taken by the department to share the recommendations on how best to care for women, pregnant women and their babies,” said department spokesperson Popo Maja.

“The measures in place to reduce the number of stillbirths in South Africa include the encouragement of early booking to monitor pregnant women’s blood pressures as this usually causes stillbirths,” said Maja. Other measures include proper management of high-risk pregnant women, timeous referral to the next level of care if needed. The department also highlighted training, monitoring, and accreditation of facilities.

The department of health also has programmes to help prevent stillbirths. The Essential Steps into the Management of Obstetric Emergencies (ESMOE) training for both doctors, midwives and emergency services is one programme. The department has also appointed district clinical specialists and makes use of ward based outreach teams. Initiatives like MomConnect and the extended NurseConnect, use mobile technology to connect mothers to health workers and maternal health services.

“We always urge all expectant mothers to book early and attend clinics according to the guidance by health care workers,” said Maja.

“Women must avoid ingesting harmful substances including unprescribed medicines and drugs. Pregnant women must deliver under the supervision of a skilled health professional,” warned Maja. “They should take medications as prescribed and avail themselves for screening to detect other health conditions.” —Health-e News


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