New Delhi: Nearly one-fourth of all stillborn babies worldwide are from India, the highest for any nation, and more than half of them could be saved by better maternal and obstetric care.
Also See | Stillbirth rate in 2008 (PDF)
A study to be published in The Lancet medical journal has found that an average of 2.6 million stillbirths occurred every year between 1995 and 2009, 23.2% of which were from India. This means an average of 1,680 babies were born dead every day in the country in that time.
This paints a dismal picture in the backdrop of emerging Census 2011 data, which points to a bias against girl children. The sex of stillborn babies was not specified in the peer-reviewed study, but it seems that deficient prenatal care is further queering the pitch for India’s women.
Although the World Health Organization (WHO) has previously pointed to the country’s exceptionally high infant and maternal mortality rate, the Lancet study, according to the writers, is the first to track regional trends over a long period.
“Unfortunately, still births don’t count in data-collating efforts for the millennium development goals. So this is a kind of first attempt at trying to capture a true picture of the problem,” said Joy E. Lawn, lead author of the research series. “Over time, we expect better numbers and data based on standard numbers to come out.”
Though several countries keep track of stillbirths, they have varying definitions. For the study, the researchers employed the definition by WHO, which terms any unsuccessful delivery after 28 weeks of pregnancy a stillbirth.
The figures, using government data and statistical extrapolation, put the global rate of stillbirths at 19 for every 1,000 births. India is in the top half of the chart with 22 still births per 1,000 in a spectrum that has Finland at two per 1,000 and Pakistan and Nigeria at 40 per 1,000.
In 2009, 98% of stillbirths were in low-income and middle-income countries and more than three quarters (76%) occurred in South Asia and sub-Saharan Africa.
Between them, just 10 countries made up two-thirds of all stillbirths. Trailing India were Pakistan, Nigeria, China, Bangladesh, Democratic Republic of the Congo, Ethiopia, Indonesia, Afghanistan and Tanzania. Zulfiqar Bhutta, a professor at the University of Karachi and a researcher involved with the study, said around two-thirds of stillbirths occurred in rural families, where skilled birth attendance was at least 50% lower than in urban areas and caesarean sections mostly unavailable.
On the optimistic side, the study said stillbirths have fallen from an estimated 3.03 million in 1995 to 2.64 million in 2009. The global stillbirth rate has been reduced to 19 stillbirths per 1,000 total births from 22.
However, at an annual rate of 1.1%, this hasn’t matched the 2.3% annual reduction in child under-five mortality and the 2.5% annual reduction in maternal mortality.
Unflatteringly, India’s stillborn rates were pretty much constant through this period, while the most remarkable reductions were registered in China, Colombia and Mexico.
The research work, which spanned 18 countries and involved 69 authors from more than 50 organizations, was conducted for more than two years and primarily funded by the Bill and Melinda Gates Foundation.
“We’ve also tried to address common misconceptions, such as that stillbirth is an inevitable loss that cannot be prevented,” said Bhutta.