Stillbirths: ending preventable deaths by 2030

This is the fifth and final article in the Lancet Series on Ending Preventable Stillbirths.  The paper summarises findings from the previous papers in the Series and proposes measures for successful integration of stillbirths into the post-2015 initiatives for women’s and children’s health.This article highlights that the number of stillbirths each year (2.6 million) remains unchanged since 2011 and is still unacceptably high. Analyses and methods

• A mapping exercise of all relevant post-2015 initiatives was carried-out to assess inclusion of stillbirths in various documents
• The structure and relationship among 33 organisations associated directly or indirectly with stillbirth-related issues was assessed

Summary of evidence from the Ending preventable stillbirth Series

• Respectful, high quality care for mother and baby can prevent stillbirths and must be part of women’s and children’s health programmes
• Half of all stillbirth occur during labour and are very preventable with high quality care at birth
• Stillbirths have received little political attention and few countries have taken forward the Every Newborn Action Plan (ENAP) commitment in national plans
• Most stillbirths occur in low income countries and mostly in rural settings
• Economic and social costs result from stillbirths, especially for women, including the stigma associated with stillbirth

Integrated mother-baby approach to stillbirth prevention and response

• Stillbirth prevention and response need an integrated approach
• Investment in high quality care before and during pregnancy and during labour is one of the most effective ways to protect the mother and baby and promote healthy child development
• Effective interventions include syphilis detection and treatment in pregnancy, and quality care during labour and birth
• Addressing gender discrimination, increasing access to sexual and reproductive health services, and improving access to primary health care before pregnancy are crucial to reducing stillbirths

Renewed Call to ActionThe article outlines a renewed call to action to end preventable stillbirths based on the evidence in support of women’s and children’s health.  The call to action aligns with the ENAP target of 12 stillbirths or fewer per 1,000 total births.  It also aligns with the Sustainable Development Goals (SDG) target of universal health-care coverage by 2030, including accessing to sexual and reproductive health services, antenatal care, and care during labour and birth. The call to action highlights five priority areas to reduce stillbirths:

1. “Intentional leadership
2. Increased voice, especially of women
3. Implementation of integrated interventions with appropriate investment
4. Indicators to measure effect of interventions and especially to monitor progress
5. Investigation into crucial knowledge gaps”

To read the Lancet Ending Preventable Stillbirths Series, click here.To read the article for free, click here.Bernis, L. De, Kinney, M. V, Stones, W., Hoope-bender, P., Vivio, D., Leisher, S. H., Bhutta, Z.A., Gülmezoglu, M., Mathai, M., Belizán, J.M., Franco, L., McDougall, L., Zeitlan, J., Malata, A., Dickson, K.E., & Lawn, J. E. (2016). Stillbirths: ending preventable deaths by 2030, 6736(15).