36 out of 1000 babies stillborn in Bangladesh
The second highest rate of stillbirth (the death of a baby before birth at or above 28 weeks of pregnancy) in Asia occurred in Bangladesh in 2009. Most of these deaths could be prevented through interventions. Urgent action needed to bring the facts of largely overlooked issue — 'stillbirths' is in the limelight.
When a pregnancy progresses towards the end (last trimester), the excitement, anticipation, joy related to upcoming baby become intense. The outstanding journey of pregnancy through pain and pleasure comes to a shattering and heartbreaking end when the baby dies in the womb in last few weeks. The mother bears the brunt of the consequences and suddenly faces scorn, isolation and rejection. Soon after delivering a dead baby, many women are being pressured to become pregnant again that ultimately put them at increased risk; sometimes spell repeated stillbirth. This is the cycle that continues in the life of thousands of women in Bangladesh.
When a baby dies at or after 28 weeks of pregnancy inside the mother's womb is called a stillbirth, according to World Health Organisation (WHO). Recently published data in the medical journal The Lancet shows that about 1,28,550 stillbirths occurred in Bangladesh in 2009 alone and the rate was alarming! 36 out of every 1000 babies were stillborns which was the 3rd highest rate in the world and 2nd in Asia after Pakistan. But the issue is not properly recognised, not only in Bangladesh but also in the global health agenda.
Although addressing stillbirth could help achieve target of Millennium Development Goals (MDG-4 and 5) of reducing child and maternal mortality, it has not yet been included in the goals and targets. Due to stillbirths, more than 7,200 parents everyday take their newborn baby home in a coffin and 98 percent of them occur in low- and middle-income countries like Bangladesh. Although this estimation shows reduction of stillbirths from 3 million in 1995 to 2.6 million in 2009, this is even slower than reductions for both maternal and child mortality in the same period.
Interventions to reduce stillbirth is not separated from those to achieve MDG. The five main causes of stillbirth are childbirth complications, maternal infections in pregnancy, maternal disorders (especially, hypertension and diabetes), fetal growth restriction and congenital abnormalities. So taking measures to prevent stillbirth will help both way.
Almost half of all stillbirths, 1.2 million, happen when the woman is in labour. These deaths are directly related to the lack of skilled care at this critical time for mothers and babies.
Experts pointed out key interventions that could avert 1.1 million stillbirths. These are- Comprehensive emergency obstetric care, Syphilis detection and treatment, Detection and management of fetal growth restriction, Detection and management of hypertension during pregnancy, Identification and induction for mothers with >41 weeks gestation, Malaria prevention, including bednets and drugs, Folic acid fortification before conception, Detection and management of diabetes in pregnancy.
Stillbirth claims more lives each year than HIV-AIDS and malaria combined. Unfortunately, it is under reported and often goes unrecorded. It is the high time to strengthen and modify policy to address stillbirths with proper interventions.
......................................
E-mail: [email protected]
Comments