Stillbirth

Women in sub-Saharan Africa and South Asia bear the greatest burden of stillbirths in the world. More than three-quarters of estimated stillbirths in 2021 occurred in these two regions, with 47 per cent of the global total in sub-Saharan Africa and 32 per cent in South Asia. In sub-Saharan Africa, the estimated stillbirth rate of 21.1 stillbirths per 1,000 total births was eight times higher than the lowest regional average stillbirth rate of 2.6 found in the Western Europe. South Asia had the second highest stillbirth rate, at 17.0 stillbirths per 1,000 total births.

Women in sub-Saharan Africa (i.e., the combination of the West and Central Africa and Eastern and Southern Africa regions ) and South Asia bear the greatest burden of stillbirths in the world

Stillbirth rate (2000–2021), by region

Number of stillbirths (2000–2021), by region

The burden of stillbirths is not distributed evenly across countries. In 2021, stillbirth rates ranged from 1.6 stillbirths per 1,000 total births to 31.2 stillbirths per 1,000 total births. The risk of a stillbirth in the country with the highest stillbirth rate was about 20 times higher than the country with the lowest rate. Of the 26 countries where an estimated rate above 20 was observed, the majority (21) are in sub-Saharan Africa and the remaining five in South Asia or Middle East and Northern Africa. Comparatively, for 20 countries – mainly in Europe – the estimated stillbirth rate was below 2.5 stillbirths per 1,000 total births. This wide gap between countries within and across regions indicates the great potential to reduce preventable stillbirths.

Most stillbirths are preventable, so long as proven interventions that improve the health of mothers and their babies along the continuum of care are available and accessed. Globally, in 2021, an estimated 45 per cent of all stillbirths were intrapartum (i.e., the baby died during labour). Almost all of these 814,000 stillborn deaths could have been prevented with access to high-quality care during childbirth, including ongoing intrapartum monitoring and timely intervention in case of complications. Around half of all stillbirths in West and Central Africa, Eastern and Southern Africa and South Asia are intrapartum, compared to 8 per cent in Western Europe. Overall, an estimated 741,700 babies died during labour in 2021 in sub-Saharan Africa and South Asia, accounting for 91 per cent of all intrapartum stillbirths worldwide. Intrapartum stillbirth is a sensitive marker of timeliness and quality of intrapartum care. Actions are urgently needed in the two regions to provide critical interventions to save lives.

Globally, some progress was made in reducing the stillbirth rate over the past two decades, which declined from 21.3 stillbirths per 1,000 total births in 2000 to 13.9 in 2021 – a reduction of 35 per cent. The total number of stillbirths also declined by 35 per cent, from 2.9 million in 2000 to 1.9 million in 2021. Notably, these declines have not kept pace with progress in under-five mortality. In many sub-Saharan African countries, the number of stillbirths stagnated or even increased, as population growth outpaced decreases in the stillbirth rate.

Without urgent action, millions of families will experience the tragic stillbirth of a baby in the next decade. If the stillbirth rate for each country stays at the 2021 level, 17.5 million babies will be stillborn between now and 2030. Even more babies could be stillborn if investment is paused and stillbirth rates increase. If the world sustains the progress made in the past two decades through 2030, 1.6 million more babies will live. The second scenario promises a better world for women and children, but one that still involves the loss of 15.9 stillborn babies from 2022 to 2030. Ambitiously, if each country’s stillbirth rate reached or fell below the current average rate in high-income countries (2.8 stillbirths per 1,000 total births) by 2030, 8.4 million lives could be saved over the sustaining current progress scenario.