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A recent feasibility study carried out at the Murtala Muhammed Specialist Hospital, Kano, indicates that Nigeria accounts for 12 per cent of stillbirths globally. A stillbirth occurs when a baby is born with no sign of life at or after 28 weeks of pregnancy or during birth. In a recent joint report, the United Nations Children’s Fund (UNICEF), the World Health Organisation (WHO), the World Bank Group and the Population Division of the United Nations Department of Economic and Social Affairs estimate that almost two million babies are stillborn every year.
This approximates to one stillbirth every 16 seconds. The report titled, ‘A Neglected Tragedy: The Global Burden of Stillbirths,’ indicates that 84 per cent of this global problem occurs in low and middle-income countries. It also said that more than 40 per cent of stillbirths occur during labour.
According to the report, Nigeria is one of the six countries where half of all stillbirths occur in the world. The rest are China, Ethiopia, India, Pakistan and the Democratic Republic of the Congo. It noted that Nigeria recorded a 15 per cent increase in the rate of stillbirths between 2000 and 2019. In 2019 alone, the country reportedly recorded about 171,428 stillbirths or 42.9 per 1,000 births. This makes it the second highest rate of stillbirths in the world. The government’s reported target is to reduce stillbirths to 27 per 1,000 live births by 2030.
In many countries, there is no accurate data to capture this global health issue. What this means is that a good number of families suffer this problem in silence and may never have access to healthcare interventions that will prevent the deaths. The major cause of these avoidable deaths is absence of skilled birth attendants, especially in rural areas. What usually happens in such areas is that some pregnant women visit all manner of quacks to attend to them and when there are complications, the quacks deploy crude methods to deliver the babies. This could result in stillbirths. The problem is compounded by lack of well-equipped primary health care centres and maternities in the rural areas.
Lack of adequate nutrition can also cause stillbirths. Some pregnant women are a bit advanced in age and neither go for antenatal nor take the necessary medication that will keep them in stable condition. This is worsened by maternal conditions like hypertension, diabetes, prolonged pregnancy, childbirth-related complications and illnesses like malaria, HIV and syphilis. Illiteracy and superstitious beliefs can also cause stillbirths. There are instances where prolonged labour demands that a caesarean section (CS) be done on a pregnant woman. But some of these women believe CS is not normal and should not be ‘their portion.’ Some may have had up to four children of the same gender through CS.
Rather than stop at that to save their lives, they will want to have more in order to get the gender they really desire. At this point, complications may set in and endanger the life of the mother and her child. Also, due to the low level of education in the North, stillbirths are said to be more prevalent in the North-West and North-Central zones of Nigeria. This health crisis has posed enormous challenge to many families who are often devastated by the loss of their babies. Some of them go through psychological and financial trauma. Some suffer one form of stigma or the other in their communities.
Stillbirth is preventable if only the government can prioritise healthcare. Pregnant women should learn to visit professionals like qualified midwives and doctors. They must go for their antenatal regularly, take their medication and good nutrition as well as keep to instructions of qualified medical personnel. Treatment of diseases such as syphilis will go a long way in preventing the problem. Family planning is also essential to prevent unwanted pregnancies that could lead to stillbirths.
Relevant government agencies should create awareness and embark on sensitisation programmes on how to prevent stillbirths. Primary health care facilities should be made available and affordable. Many countries are not yet near the target of the World Health Assembly, which in 2014, endorsed what it called the Every Newborn Action Plan (ENAP). This plan targets 12 or fewer stillbirths per 1,000 total births in every country by 2030. It will be good if Nigerian health authorities ensure that the country meets this target as scheduled.
