This article is part of the supplement: Stillbirths – the global picture and evidence-based solutions

Open Access Open Badges Review and methods overview

3.2 million stillbirths: epidemiology and overview of the evidence review

Joy E Lawn123, Mohammad Yawar Yakoob4, Rachel A Haws5, Tanya Soomro4, Gary L Darmstadt5 and Zulfiqar A Bhutta4*

Author affiliations

1 Saving Newborn Lives/Save the Children-US, Cape Town, South Africa

2 Center for Health and Development, Institute of Child Health, London, UK

3 Health Systems Research Unit, Medical Research Council of South Africa

4 Division of Maternal and Child Health, The Aga Khan University, Karachi – 74800, Pakistan

5 Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA

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Citation and License

BMC Pregnancy and Childbirth 2009, 9(Suppl 1):S2  doi:10.1186/1471-2393-9-S1-S2

Published: 7 May 2009


More than 3.2 million stillbirths occur globally each year, yet stillbirths are largely invisible in global data tracking, policy dialogue and programme implementation. This mismatch of burden to action is due to a number of factors that keep stillbirths hidden, notably a lack of data and a lack of consensus on priority interventions, but also to social taboos that reduce the visibility of stillbirths and the associated family mourning. Whilst there are estimates of the numbers of stillbirths, to date there has been no systematic global analysis of the causes of stillbirths. The multiple classifications systems in use are often complex and are primarily focused on high-income countries. We review available data and propose a programmatic classification that is feasible and comparable across settings. We undertook a comprehensive global review of available information on stillbirths in order to 1) identify studies that evaluated risk factors and interventions to reduce stillbirths, 2) evaluate the level of evidence for interventions, 3) place the available evidence for interventions in a health systems context to guide programme implementation, and 4) elucidate key implementation, monitoring, and research gaps. This first paper in the series outlines issues in stillbirth data availability and quality, the global epidemiology of stillbirths, and describes the methodology and framework used for the review of interventions and strategies.