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What can be done about stillbirths in Africa?

Africa HYS team | 17:43 UK time, Wednesday, 13 April 2011

Every year thousands of babies die before or during labour. Why is this happening?

In a BBC Africa Have Your Say health special, we hope to discover more about this traumatic phenomenon. Only now the first comprehensive set of stillbirth estimates are being published despite the fact that the experience can be devastating for families. Often these deaths are not talked about in the open, and what is more they are not even recorded in child mortality statistics.

Have you or someone you know had to cope with having a stillbirth? Is there any support in place to help families cope? 

If you have any questions you would like to ask or experiences you would be prepared to share on Thursday 14 April at 1600 GMT, please include a telephone number. It will not be published.


  • Comment number 1.

    The problems leading to stillbirth in Africa are not different from the problems leading to inhuman suffering of those who are born well and are living or better said existing in Africa so the solution will go simulteneously . It is the same bad governance in Africa resulting to total lack of all live supporting amenities like good feeding , medical treatment, education , water etc that made life to be painful to those who are born well and are living / existing in Africa , the [Unsuitable/Broken URL removed by Moderator]same problem also leads to still birth because a lot of pregnant women go about hungry , no antenatal consultaction and generally in pain and regret of coming to earth . Who then will be suprised that a disillusioned / hungry / sad pregnant woman gave birth to a dead baby???

  • Comment number 2.

    To reduce high rate of deaths in Africa, every year thousands of babies die before birth is to end poverty, and to end endless wars and eradicating diseases that created pandemics diseases.

  • Comment number 3.

    Investing in the people is the solution to most of Africa's problems. This means investing in infrastructure including Hospitals & Clinics, education, water, electricity, jobs etc (all of which would directly affect the rate of stillbirths). The answer is almost the same for all of Africa's problems & cuts across all the countries in Africa & all developing countries for that matter.

  • Comment number 4.

    Still birth is one of the many health challenges facing Africa just like other countries. Yes, the situation in Africa may sound more critical. However, the issues that pertain to still birth may be many and complex.
    First, the health policies and health service delivery may not be in sync. This could be due to resource constraints and allocation challenges.
    Second, the medicine supply in Africa, just like in developed world, is full of fake sold as generic. Some of the medicines may be cause of the still birth.
    Third, the diet we feed on may not be healthy enough as from it we get cholesterol, trans fat and many chemicals that are harmful to the body.
    Fourth, health has been institutionalized to the point that natural remedies are considered in the negative. This may be right but may also be wrong because still birth must have been handled in the traditional society.
    Fifth, I want to propose that all stakeholders be allowed to handle the still birth challenge from a broader perspective.

  • Comment number 5.

    The word "phenomenon" is the wrong one to use I think, it implies that we don't know why it's happening. I can tell you from experience that it is a combination of a lack of education and delayed interventions. Many women in African countries do not receive prenatal care and if they do, many of them still do not understand why certain procedures are necessary. Many also refuse to go to the hospital or see a doctor. I have seen a great number of Ceasarian sections that were absolutely necessary due to obstructed labour be postponed because the husband, the family or the Mother would not agree to it. Some, run away, never to be seen again, a simple "R/A" is written on their charts. Others run away and come back a day or two later and the baby is dead by then. Others still, remain at the hospital and eventually agree to the procedure but, again, it is still too late. There are mothers who try to deliver at home in their villages first and arrive at the hospital when something has already gone wrong and no one was there to monitor them. The age of women who typically give birth does not help either, many of them are a prime gravida (first time mother) at the age of 14, 15 or even younger. These women's bodies are often malnourished and not nearly developed enough to push a baby through their not yet fully widened pelvises. They need to seek prenatal care and medical attention before problems begin instead of waiting until there is already a problem and expecting a hospital that is often poorly equipped to try and fix it. Also, it would help if the hospitals all had generators so that they didn't have to try and deliver babies by candlelight at night if the power goes out and so that surgeons would be able to perform the necessary Cesarians and the patients wouldn't have to wait until power was restored. Spend a few months in a maternity ward there and you'll know exactly what I'm talking about.

  • Comment number 6.

    Nothing can be done. What can be done about corruption in Africa? - Nothing. When this problem of corruption shocking governance dealth with, then we can begin to speak of doing something about still births. It's like asking what can be done about lack of education or medical facilities? Answer - Nothing. Not until the leaders change their mindsets

  • Comment number 7.

    Research on this very subject in Zaria Nigeria in the 1970s showed that most stillbirths were normal sized well formed babies who died before admission to hospital. This is most pronounced in babies whose mothers acquired obstetric fistula (VVF). To this day, the position remains the same country wide. Hence the need is for better obstetric care especially prompt and bold operative interference, for example, safe caesarean section, before it is too late. It is important for us to realise that high still birth rate in Nigeria is due to bad obstetric care. But bad obstetric care is caused largely by an underlying disease which is the chaos (social, political, educational, infrastructural) in the country. Hence, the permanent solution to the problem lies in getting our politics right.

  • Comment number 8.

    I have no doubt that better and accessible pre-natal care in African countries will reduce stillbirths to the barest minimum.
    Low infant mortality and higher life expectancy can all be linked to accessible, quality health care and other good qualities of living, such as: clean water, good nutrition, clean housing/shelter and clean or pollution-free living environment etc.
    Education and Healthcare are free to all Cubans. Which explains, why Cuba, a poor country has a lower infant mortality rate than the U.S. - the richest country on the planet. Unfortunately, like in America, millions of Africans have no health insurance and access to healthcare, while a few rich and powerful get the best healthcare money can buy either at home or abroad. But, mostly abroad.

  • Comment number 9.

    What exact country are you talking about here, BBC? Surely there cannot be a still-birth epidemic in the entire continent of Africa, right?

  • Comment number 10.

    The still births are becoming quiet common in our communities and sometimes the health providers do not tell expectant mothers what causes such still births. Is it the type of foods we take during expectant period?I had a colleague who lost her first pregnacy due to stillbirths she was crying all day long and she did not want to see the hospital building. So my advice to the health providers need to sensitize women on what type of foods to take during incubation time.

  • Comment number 11.

    Hell yes. You are justified to perceive that Every year thousands of babies die before or during labour. I blame it all on leaders (politicians) of the wretched African countries.....ask me being an African my self and happen to bear the name of the continent. How can the poor African women , mainly in rural areas, with their little earnings from their subsistence led agriculture escape from the wrath and grip of maternal death? When Global fund gives money to Uganda to use in eradicating HIV/Aids and Malaria(many pregnant mothers in Uganda for, example have miscarriages because of malaria in areas where Millennium villages project under UNDP has not reached, for in its areas of operation including my area of abode, it has provided free mosquito nets to every household member) the money has been squandered/ embezzled by the shameless, uncultured ministers of the related sector, leading to thousands of children to die of what President Barack Obama in his speech while in Ghana called "curable diseases, a key significance of underdevelopment and poverty".
    Countries like Uganda have decentralized the health service delivery by constructing health center 4,2 but these health cent-res are not equip ed with drugs: they are put in place but equipped/empowered with a lot of nothing, and not because the government does not send drugs, but because medical personnel in such hospitals steals the drugs and puts it in their respective private clinics.(Thanks to MVP and UNDP that they have rejuvenated those hospitals by constantly supplying them with medicine like coartem that has made patients get access to free medicine/treatment). When a patient comes to such hospitals, the Doctor prescribes for them the medicine and sends them to buy it, ironically from his clinic. This medicine, like all exploiters, is always highly priced that peasants with their meager earnings can not afford. So their option is just to buy half a dose and when they feel a little better before they have finished the whole dose, they won't go back not because they don't desire to but because they are deprived of money to buy the last dose. This action only results into speeding up of malaria the more and its reaction increases. Poverty of households in Africa plus the in efficiency and corruption of the medical personnel has helped perpetrate the e'er increasing child mortality rates. If the above named sect became "just a little" considerate, child mortality would reduce.
    Some mothers still produce from home with out proper attention of a trained Doctor and so that is why they contract diseases like HIV/Aids and tetanus since the traditional birth attendants always use rusty razorblades to cut the umblical cord and it is no wonder that such children born under the aforesaid circumstances don't live to see their fifth birth day. The UNDP has indeed helped reduce child births in areas of its operation like in Isingiro county south, Isingiro district, Uganda but the government should feign from only institutionalizing un functioning and in efficient institutions., or otherwise, death gong will continue to sound for a peasant African child.

  • Comment number 12.

    I just spent four months working in the maternity ward of a Ugandan, government funded hospital. The surgeons knew what they were doing I can tell you that much. They do the best they can with what they have and the head of the maternity ward that I worked with cared a great deal about his patients. He's even been doing his own investigations as to why there are so many still births and maternal deaths. The truth is that there are more deaths due to complications in pregnancy and childbirth then HIV/AIDS, tuberculosis and malaria combined. So yes, it is a HUGE deal. These hospitals were equipped with drugs but all was fairly basic. What they needed more of was equipment such as oxygen concentrators so that when the oxygen tanks were empty and they had to go to Kampala to get them filled, they would have a backup. I saw countless babies die because of a lack of oxygen when the machine was either broken or empty. You could blame politics, which is like all things, at the root. But there is also the fact that well, in Uganda's case, there are services available, even at the public hospitals. They offer free prenatal care and counseling services in the bigger towns. When you go into labour, get to a hospital as soon as you can or at the very least, have a midwife with you. Birthing attendants, well it says it in the name, are attendants, they "attend" births. They are great for support and in catching a baby, but if something goes wrong, there's pretty much nothing they can do yet many women still rely solely on them. Pregnant women and their families need to be less afraid of hospitals and doctors and be proactive when it comes to learning about pregnancy. In terms of nutrition, asides from alcohol and large amounts of caffeine, there is not much that would result in the death of a full-term baby, so that is not the issue. The only particularly important addition to the diet would be folic acid to prevent neural tube defects. There will be times when medical staff will have no answers as to why a baby died during or before birth, but that's in the developed world too. The hospitals should become more hygienic as infection is rampant and they do need more equipment. They should also be monitoring every mother who is in labour with a partogram to see how she is progressing. But overall, women need to start taking advantage of the services available to them and get themselves to the hospital, even a public one as there they only have to pay for gloves, syringes and a birthing kit. The fact is that if they can't afford to get themselves there and to pay for those amenities, that child will have a pretty hard time surviving anyway. I'll say it once and I'll say it again though, it is mostly due to delayed interventions (either due to fear of hospitals and procedures causing too much time to elapse before seeing medical attention, a lack of transportation, etc). All of this is usually rooted in a lack of education and/or money and in the end, resulting in a large number of stillbirths and fistulas because the baby couldn't come out without help. Bottom line is that the services need to be there, but most importantly, people need to take advantage of them and know that the medical staff are there to help, trust me, I've watched them and worked with them, they are good people. They want to help, but they can't if people refuse to let them operate or don't come to them until it's too late. Many of the stillbirths that I saw were macerated, meaning the baby had been dead for over 24 hours, therefore intervention had been delayed for far too long.



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