Still births can be halved
By Dr Arvind Kumar
According to a recent paper published in The Lancet medical journal and reported by IRIN newsagency, preventing stillbirths can cost just US$2.32 per mother if governments, the private sector and international institutions adopt a package of 10 health interventions, rather than allowing stillbirths to be an almost invisible problem. It is reported that if ten recommended interventions were 99 percent implemented in 68 priority [low and middle-income] countries, the number of stillbirths could be halved. Even if the interventions were 60% covered, stillbirths could be reduced by one-quarter. Some 2.64 million foetuses die after the 28th week of pregnancy, mostly in low- and middle-income countries. Interventions identified by the research paper include: basic and comprehensive emergency obstetric care; skilled care at birth; detection and management of foetal growth restriction; detection and management of hypertension in pregnancy; elective induction in post-term pregnancies; insecticide-treated bed nets and intermittent prophylaxis to prevent malaria; detection and treatment of syphilis; folic acid supplementation; and management of diabetes in pregnancy.
Asserting that stillbirths have largely been neglected in policy prioritizing for a variety of reasons, the Paper says: “There was little in terms of verified data for stillbirths and even less for its categories – whether intrapartum [during childbirth] or antepartum [before childbirth] – and risk factors, and little confidence that interventions could make a difference.” The Lancet series hopes to change this perception by re-framing stillbirths so that they are not seen as an unexplained event that occurs in the womb, but as something that is potentially preventable if appropriate care is given during pregnancy and birth.
