Losing a baby before you could even hear their first heartbeat should be something no parent should have to experience. And as it continues to happen to mothers worldwide, it’s important to find more ways to prevent it.
In 2019 alone, around 2 million stillbirths occurred worldwide according to UNICEF. With the inclusion of 73 stillbirths in Singapore and overall 97 perinatal deaths registered as recorded in the 2019 Report on Registration of Births and Dates.
But with the pandemic ongoing, researchers have found that there has been a significant rise in pregnancies ending in stillbirths around the world. Studies from different countries have said that many pregnant women did not receive proper healthcare due to lockdown restrictions, resulting in delivery complications such as stillbirth.
A Spike In Chances Of Stillbirth Among Pregnant Women
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In a study led by perinatal epidemiologist Ashish K.C. published in The Lancet Global Health, researchers found a rise in stillbirth rate according to data collected from over 20,000 women who gave birth in 9 Nepal hospitals. Before the country went into lockdown, there were 14 stillbirths recorded per 1,000 births. But in late March when COVID-19 restrictions were made, stillbirth cases increased by 50% with 21 per 1,000 births by the end of May. The spike was said to be prominent during the first four weeks of the lockdown.
The overall number of births didn’t change despite the rise of stillbirths since researchers believed it was due to hospital births decreasing from an average of 1,261 births each week before the lockdown to only 651. Many of which had complications in birth during the lockdown.
K.C. and his colleagues could not confirm whether the rate of stillbirths increased through the overall population since they had no way of knowing what happened to pregnant women who didn’t go to the hospital.
They also clarified that it was not exactly due to COVID-19 that caused the increase of stillbirths in hospitals but rather because of how it affected access to routine antenatal care, which could have helped pick up any birth complications.
Due to the lockdown and the lack of public transport, pregnant women might have been unable to travel to health facilities. In contrast, others were reported to have their antenatal appointments cancelled. There is also a possibility that some of them preferred not to visit the hospital to avoid getting infected and had consultations through online or by phone instead.
More Countries Report Rise Of Stillbirths
In London, St George’s Hospital also found a spike in stillbirth cases. Researchers reported an increase from 2.38 per 1,000 births between October 2019 and January 2020 to 9.31 per 1,000 births between February and mid-June 2020.
Asma Khalil, an obstetrician at St George’s, said that pregnant women might have been hesitant to visit the hospital during the lockdown and could have developed complications that were not diagnosed. It was also found that when they did see the doctor, it was only when there were already complications and in situations where less could be done.
Meanwhile, four hospitals in India also reported an increase in stillbirth rate during the lockdown and fewer women gave birth in these hospitals. It was also found that referrals of women requiring emergency pregnancy care dropped by two-thirds. Researchers said there is a possibility more births were happening unattended whether at home or in small facilities.
Scotland is one of the few countries that collate monthly data on stillbirths and infant deaths, and they also found a jump in stillbirth rate within the months of the pandemic.
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Call For Support For Maternal & Newborn Health
Pregnant women need to get regular check-up appointments, especially during the last trimester. The World Health Organization has even recommended that women meet with medical professionals at least eight times while pregnant to detect and manage any complications for the mother, the baby or both.
To avoid any chances of stillbirth, pregnant women may consider:
- Sleeping on their side from 28 weeks’ gestation
- Stop smoking
- Immediately contacting the midwife or doctor if there are any problems like their baby seems to be moving less.
Caroline Homer, a midwifery researcher at the Burnet Institute in Australia, said that these studies are a “call to arms” to support maternal and newborn health services and how “this is not the moment to reduce” these services. But further studies need to be made to understand the effects of the pandemic on pregnancies as Pat O’Brien, the vice-president of the Royal College of Obstetricians and Gynaecologists in London, said there still needs to be further information regarding the rise of stillbirth rates.
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