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Reducing the incidence of stillbirth in black women

02 May 2020
13 min read
 Pregnant women from minority groups need to have access to preconception and antenatal care to reduce stillbirths
Volume 28 · Issue 5

Abstract

Black and black British women have an increased risk of stillbirth in the UK. The stillbirth rate for the UK in 2017 has reduced to 3.74 per 1 000 total births. However, mortality rates remain high for black or black British women, despite stillbirth rates for these groups reducing over the period 2015–2017 from 8.17–7.46 per 1 000 births (Draper et al, 2019). These facts raise the question of why these trends continue and what steps can be taken to address this issue. This paper explores the possible reasons why black and black British women continue to be at increased risk for stillbirths. Recommendations will be made on reducing the risk of stillbirth and the importance of tailoring health services for black and black British women. For the purpose of this paper, the term ‘black women’ will be used for black and black British women.

A stillbirth is a baby delivered at or after 24 weeks of pregnancy showing no signs of life, irrespective of when the death occurred. The UK is noted to have one of the highest stillbirth rates in high-income countries (NHS England, 2016a). The stillbirth rate for the UK in 2017 has reduced to 3.74 per 1 000 total births from 4.20 in 2013 which represents 350 fewer stillbirths (Draper et al, 2019). However, stillbirth rates continue to be high for black women in the UK at 7.46 per 1 000 births in 2017 (Draper et al, 2019). This prevalence is also reflected in other European countries.

In a systematic review involving 13 separate studies in the UK, US, Denmark and Norway, which included 15 124 027 pregnancies and 17 830 stillbirths, it was found that black women were 1.5–2 times more likely to experience a stillbirth (Muglu et al, 2019). The stillbirth rate is an indicator of quality care in pregnancy (de Bernis et al, 2016). A fact that should move the prevention of stillbirth to the top of any national health promotion agenda. It is argued that the need to develop and implement a plan to improve maternal and neonatal health in any country should include a focus on reducing stillbirths (Goldenberg et al, 2011). Suggestions include increasing awareness of stillbirths in high-risk groups with the use of appropriate interventions targeted at high-risk communities (Flenadyl et al, 2016).

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