Stillbirth

Key and Emerging Evidence

This page includes a maternal mental health (MMH) landscape analysis, select sessions from a global MMH technical consultation, a systematic review on This page includes a curated list of select resources presenting key evidence on the global burden of stillbirth, priority actions for ending preventable stillbirth, as well as resources related to stillbirth and COVID-19.

Global, Regional, and National Estimates and Trends in Stillbirths from 2000 to 2019: A Systematic Assessment,

The Lancet, 2021.

This first-ever joint stillbirth estimates by the United Nations Inter-Agency Group for Child Mortality Estimation presents the number of babies that are stillborn every year due to pregnancy and birth-related complications, the absence of health workers and basic services. The report also notes that there is a high risk that the COVID-19 pandemic will increase the number of stillbirths. The report calls out a need for better measurement and data of stillbirths as well as improved quality of care during pregnancy and birth.

The first section of the recorded “Data and Parent Voices to End Preventable Deaths” session with UNICEF’s Lucia Hug, from the AlignMNH Opening Forum in April 2021, unpacks the findings in the estimates report.

Key Findings

  • Mental health remains underfunded and often ignored in the face of more visible physical health concerns. The global treatment gap for mental health disorders is estimated at nearly 90%.[1]
  • CPMDs pose significant and lasting implications for women’s health and quality of life, and have been associated with adverse development in newborns and children.[2]
  • Perinatal mental health needs to be better integrated across multiple health sectors and sectors outside of health, away from centralized institutions to the primary care and community level, and into health care provider education and practice.
  • Future research should include findings from different contexts, avoid inappropriate generalization, generate more evidence for vulnerable populations, expand beyond postnatal depression, center on the expressed desires of women, and explore integrated approaches that improve both women’s and children’s health at scale.

A Neglected Tragedy: The Global Burden of Stillbirths

UN Inter-agency Group for Child Mortality Estimation, 2020.

While the nature, prevalence, and determinants of mental health conditions in women during pregnancy and in the year after birth have been heavily investigated and researched in high-income countries, the perinatal mental health of women living in LMICs is not as widely researched. The systematic review summarizes the nature, prevalence and determinants of CPMDs in women living in LMICs.

Stillbirth rates by country (2019) from A Neglected Tragedy: The global burden of stillbirths – UNICEF DATA

Key Findings

  • Mental health remains underfunded and often ignored in the face of more visible physical health concerns. The global treatment gap for mental health disorders is estimated at nearly 90%.[1]
  • CPMDs pose significant and lasting implications for women’s health and quality of life, and have been associated with adverse development in newborns and children.[2]
  • Perinatal mental health needs to be better integrated across multiple health sectors and sectors outside of health, away from centralized institutions to the primary care and community level, and into health care provider education and practice.
  • Future research should include findings from different contexts, avoid inappropriate generalization, generate more evidence for vulnerable populations, expand beyond postnatal depression, center on the expressed desires of women, and explore integrated approaches that improve both women’s and children’s health at scale.

The 2016 Lancet Series on Ending Preventable Stillbirths

Published in January 2016, this Lancet series on ending preventable stillbirths remains a critical global resource in highlighting missed opportunities to prevent stillbirth, identifying actions to accelerate progress to end preventable stillbirth, and issuing a still-relevant call to action covering three distinct areas for improving care and outcomes for all mothers and their babies and specifically for women and families affected by stillbirth.

Priority Actions

The executive summary outlines five priority actions to change the stillbirth trend:

1. Mortality targets by 2030 (included in the Every Newborn Action Plan)

• National level: 12 stillbirths or fewer per 1000 total births in every country

• Subnational level: All countries set and meet targets to close equity gaps and use data to track and prevent stillbirths

2. Universal health care coverage targets

• Family planning: By 2020, 120 million more women and girls with access to contraceptives; by 2030, universal access to sexual and reproductive healthcare services and integration of reproductive health into national strategies and programmes

• Antenatal care: By 2030, universal quality of care and comprehensive antenatal care for all women

• Care during labour and birth: By 2030, effective and respectful intrapartum care to all women in all countries

3. Milestones

• Respectful care, including bereavement support after a death: By 2020, global consensus on a package of care after a death in pregnancy or childbirth for the affected family, community, and caregivers in all settings

• Reduce stigma: By 2020, all countries to identify mechanisms to reduce stigma associated with stillbirth among all stakeholders, particularly health workers and communities

• Every Newborn global and national milestones met by 2020, including the Measurement Improvement Roadmap (tracked by UNICEF/WHO)

Tracking Progress Towards These Ending Preventable Stillbirths Targets and Milestones 

The International Stillbirth Alliance’s Stillbirth Advocacy Working Group created a Global Scorecard for Ending Preventable Stillbirths to track progress towards the call to action. The 2020 scorecard is now available.  


Potential Impact of Midwives in Preventing and Reducing Maternal and Neonatal Mortality and Stillbirths: A Lives Saved Tool Modelling Study

The Lancet Global Health, 2021.

This study from UNFPA, and the associated brief and infographics, document the potential impact of midwives in preventing and reducing maternal and newborn mortality and stillbirths. The study is based on modelled estimates of deaths averted in 88 low- and middle-income countries that account for over 95% of global maternal and newborn deaths and stillbirths. These countries have severe health workforce shortages: they are home to 74% of the world’s population but just 46% of the world’s doctors, nurses and midwives.


Resources on Stillbirth and COVID-19

These select resources, curated and collected by the International Stillbirth Alliance and the Partnership for Maternal, Newborn, and Child Health (PMNCH), consider the global burden of stillbirth in light of the impact of COVID-19. They include select evidence-based information and multimedia assets about pregnancy and COVID-19, and discuss how the COVID-19 pandemic stands to increase the tragedy of stillbirth. Additional information related to COVID-19 and pregnancy, birth, and newborn care on the AlignMNH Knowledge Hub here.