Standing Up for Stillbirth (2024) – Annotated summary of the UN IGME report.
Every day, more than 5,000 women worldwide experience the loss of a child before birth.
In 2023, about 1.9 million babies were stillborn after the 28th week of gestation.
This is a dramatic figure, equating to 14.3 in utero deaths per 1,000 births.
Despite an overall reduction in natimortality of about 37 percent since 2000, progress remains slow and insufficient. Intrauterine deaths are an invisible health emergency, often silenced and underreported in official data, policies and public debate.
Geographical and social inequalities
The distribution of intrauterine deaths (stillbirth) is not random: it reflects deep structural inequalities. 79% of intrauterine deaths in 2023 occurred in sub-Saharan Africa (48%) and South Asia (31%), two regions that together account for half of the world’s births. The average rates of in utero deaths are:
- 22.2 per 1,000 births in sub-Saharan Africa
- 16 per 1,000 in South Asia
- 2.8 per 1,000 in Europe, North America, Australia and New Zealand
Low-income countries show 8 times higher risk of stillbirth than high-income countries. Fragile and conflict-affected settings also show double the rates compared to stable regions.
Who is most at risk?
The probability increases in the presence of:
- Poverty and low maternal education
- Residence in rural or remote areas
- Very young (<20 years) or advanced (>40 years) maternal age
- Short intervals between pregnancies (<15 months)
- Lack of access to quality prenatal and obstetric care
The most disadvantaged mothers – socially, economically and geographically – pay the highest price in terms of lives lost.
Ensuring high-quality care for all mothers and babies: reducing intrapartum deaths everywhere
One of the most serious findings of the report is that more than 46% of intrauterine deaths occur during labor (intrapartum deaths). This type of death is often preventable if delivery occurs in the presence of:
- Qualified health personnel
- Continuous fetal heart rate monitoring
- Timely emergency response
In high-risk regions, such as sub-Saharan Africa, 1 in 2 stillbirths is intrapartum.
In Europe and North America, only 1 in 12.
The data crisis: “uncounted” = “unprotected”
One of the main causes of slow progress is the lack of reliable data. The report complains that:
- 1 in 4 countries does not produce quality data on in utero deaths
- Less than half distinguishes whether death occurs before or during labor
- Official estimates are limited to deaths beyond week 28, excluding those between weeks 22 and 27 (which would add an additional 30 percent of cases )
To address this silent crisis, every death must be recorded, analyzed and recognized. Better data collection systems, standardized definitions and reduced stigma that hinders reporting are needed.
Slowdowns and delays: a race against time
Whereas between 2000 and 2015 the annual rate of reduction in in utero deaths was 2.5 percent, between 2015 and 2023 it dropped to 1.1 percent. At this rate:
- 13 million babies will be born dead by 2030
- 53 countries will not meet the EWENE target of <12 stillbirth/1000 by 2030
- In 32 countries the target will not be reached until after 2050
The contrast is striking: while under-5 deaths have declined by more than 50 percent, intrauterine deaths have shown much slower progress. The share of stillbirth in total infant deaths is increasing.
The good news: you can change course
Nevertheless, 28 countries-including low-income countries such as India, Nepal, and Bangladesh-have managed to reduce their stillbirth rates by more than 50 percent between 2000 and 2023. The key?
- Effective health policies
- Continued investment
- Monitoring systems
- Midwifery training
These successes show that change is possible, even in fragile contexts, if we invest with intelligence and political will.
The 7 key actions to prevent in utero death
The report proposes seven concrete priorities:
- Count every death, with timely and disaggregated data
- Improving the quality of health information systems
- Standardize definitions according to WHO’s ICD-11
- Ensuring universal access to quality obstetric care
- Provide psychological and social support to affected families
- Addressing stigma and taboos with cultural and health campaigns
- Integrating prevention into national and global health plans
In utero death is a key indicator of the quality of health care, but also a mirror of justice and human rights. The UN IGME 2024 report calls on the global community to recognize the value of every life, even those who could not breathe. Taking action means counting every child, treating every mother, and bringing preventable deaths to zero.
Invisible grief: grief, stigma, loneliness
In utero death is a severe traumatic event that leaves deep marks on the mental and physical health of mothers and families. However, most affected women do not receive psychological support or compassionate care.
Gathered in the report are touching testimonies from around the world: women who have not been able to see their babies, who have been moved to rooms with live infants, or who have been prevented from experiencing acknowledged grief.
Every mother has the right to mourn, to remember, and to receive respectful and trauma-informed care.
In nearly twenty years of operation, CiaoLapo has offered free support to thousands of bereaved families and trained thousands of hospital workers free of charge, changing the culture of care for in utero death and perinatal bereavement in Italy.
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