Three million babies and mothers lives could be saved in poorer countries
The terrible toll that inadequate medical care exacts on mothers and newborns, in developing countries, is highlighted in a set of articles, the Stillbirths Series, published in this week's Lancet. The 8 papers there look at the hidden trauma and loss from stillbirths, one the top five causes of deaths across the world. And the price tag that the Lancet puts on saving nearly 3 million newborns and mothers from that tale of loss annually is just $2.32 per head.
Stillbirth rates are one aspect of health that shows a massive inequality between the rich developed countries, and the poorest sections of the global village. Fewer than 1 in 200 pregnancies in the richest societies ends in the death of a baby, before or during labor. But in many parts of less developed countries, such as Pakistan, Afghanistan or Nigeria, those rates hit 1 in 25 of every pregnancies.
That is an incalculable sum of human unhappiness and lost human potential - an emotional burden that is made worse by the stigma that is often laid at the door of mothers of stillborn babes. That stigma has also made stillbirths an aspect of health-care that is often overlooked. For example, there are no targets on reducing stillbirth rates in the UN's Millennium Development Goals.
But recently, the UN has tried to rectify this, and has set itself the target of dramatically reducing these deaths. The Global Strategy for Women's and Children's Health aims to help to save 16 million lives, over the next 5 years, including reducing stillbirths. In order to achieve that objective, what is needed are funds to widely deploy some simple well-known interventions - ones that have already banished stillbirths to the margins for mothers in the developed world.
Comprehensive emergency obstetric care is top of the list, as are methods to detect and treat common complications - such as fetal growth restriction, hypertension and syphilis. These could prevent some 1 million stillbirths. Professor Zulfiqar Bhutta, from The Aga Khan University, Pakistan, identifies several other critical measures. ''An additional 1.6 million deaths of mothers and newborns could be averted if you add five additional interventions beyond stillbirth interventions, such as antenatal steroids and neonatal resuscitation. This is all highly doable and would save 2.7 million lives - a massive achievement.''
And the cost - around $10 billion dollars per year, split across 68 of the most vulnerable countries - is barely the cost of a single modern nuclear power plant. In addition to enabling a multitude of parental joy, the money would enrich society as a whole, in the long term. Robert Pattinson, from South Africa's Medical Research Council emphasized that ''this would provide a triple return for every dollar invested since these interventions can prevent stillbirths as well as save mothers and newborns.''