Stillbirths in Bangladesh: A preventable public health emergency

In a corner of the hospital room, Shahnaz sat by the window, her eyes distant. Just a few weeks earlier, she had been eagerly preparing for the arrival of her first child. With teary eyes, she shared how she and her husband had picked out names and imagined a future filled with tiny clothes and lullabies. But her dreams were cruelly cut short when she lost her baby in the seventh month of pregnancy.

"I had been feeling weaker for days," Shahnaz said, her voice barely above a whisper. "There was swelling, dizziness, but I thought it was normal in pregnancy." She had not seen a doctor in months, relying instead on home remedies and advice from neighbours.

"Eventually, my husband insisted we see a doctor when my condition worsened. I finally went to the hospital. They said my baby had no heartbeat. It was too late." She looked down at her hands and added quietly, "This is all my fault. Maybe if I had gone earlier, things would have been different."

The news of her baby's stillbirth left her numb. The heartache, disbelief, deep shock, and guilt—emotions that many mothers in Bangladesh carry for years—are rarely spoken about openly.

A heartbreaking reality

According to a recent report by the United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME), Bangladesh records over 63,000 stillbirths annually. That means for every 41 births, one baby is born without life—the highest rate in South Asia.

While Bangladesh has made notable progress in maternal and child health since 1990, the statistics expose a deep and persistent crisis that too often remains hidden in silence.

One major factor behind the high number of stillbirths is that nearly 30% of all births in Bangladesh still take place at home, frequently without skilled medical assistance. Complications that could be managed in a hospital setting often become fatal without trained support. Without skilled hands, risks that could have been mitigated early can escalate into life-threatening emergencies.

Inadequate postnatal care, the absence of round-the-clock health services in many upazila health complexes, and inconsistent medical practices in the unregulated private sector all contribute to avoidable deaths.

"Stillbirths remain a heartbreaking reality. While Bangladesh has made significant progress, disparities in access to quality and timely care persist," said Dr Ahmed Jamsheed Mohamed, WHO Representative in Bangladesh.

The missed warnings

The risks start much earlier than the delivery room. Dr Nusur Akhter, an obstetrician and gynaecologist, explained that skipping regular check-ups during pregnancy is a major reason why problems go undetected. "When mothers forgo antenatal care, critical health issues in both the mother and baby can remain hidden, and this significantly contributes to stillbirths," she said.

She frequently sees cases where mothers suffer from high blood pressure, eclampsia, uncontrolled diabetes, anaemia, or early labour—all of which could be detected and managed with proper monitoring. Without early diagnosis and medical intervention, these conditions silently worsen and lead to devastating outcomes.

Dr Nusur highlights warning signs such as severe headaches, blurred vision, rapid weight gain, vaginal bleeding, and extreme fatigue during pregnancy. She stresses the importance of preconception counselling, regular antenatal check-ups, taking prescribed medication, and following up on health advice. These seemingly simple but vital steps could save countless lives.

She also points to broader societal barriers. Many women miss out on crucial care due to lack of education, limited awareness about maternal health, and low levels of empowerment. Often, women are unable to recognise when something is wrong—or are simply not in a position to seek help when they need it most.

Ferdousi Begum, President of the Obstetrical and Gynaecological Society of Bangladesh, added that expectant mothers younger than 16 or older than 35, those with conditions such as diabetes, obesity, or infections, and pregnancies extending beyond 42 weeks, all face significantly heightened risks.

"Taking six to eight times more steps in ensuring maternal and child health than we currently do could dramatically reduce stillbirths, neonatal deaths, and maternal mortality," she said.

Alarmingly, about 40 to 60% of stillbirths occur at the very end of the labour process—primarily due to delays in reaching a hospital or a failure to act appropriately once there.

Where the system falls short

Bangladesh needs to save an additional 28,000 newborns each year to meet its Sustainable Development Goal (SDG) targets for child health. Experts stress that reaching this target requires more than just good intentions—it demands urgent, sustained investment in primary healthcare.

The unregulated healthcare sector further complicates matters. In the absence of strong oversight, the quality of care varies widely. Many families—often desperate and overwhelmed—turn to facilities that lack the training or infrastructure to handle complications. Meanwhile, poor antenatal care, inconsistent postnatal follow-up, and chronic resource shortages in public hospitals continue to claim lives that could have been saved.

Strengthening upazila health complexes, equipping them with skilled professionals—especially midwives—and ensuring 24/7 availability of quality maternal and newborn care is not just advisable; it is essential.

"We need to invest more in healthcare and trained professionals to ensure safe births," said Farook Adrian Doomun, Deputy Representative of UNICEF Bangladesh.

Experts like Dr Nusur argue that technical improvements alone are insufficient. Raising public awareness, expanding health education at the grassroots, and empowering women to seek timely care and make informed decisions about their bodies and pregnancies are equally critical.

Community-based programmes, better access to reliable information, and stronger support networks could prevent many silent tragedies before they unfold.

A call to act

Yet, while we continue to wait for systemic reforms, more mothers like Shahnaz are left with grief that might have been avoided. This is a quiet but urgent reminder: behind every statistic lies a future lost too soon, a family torn apart, and a mother left asking what might have been.

Change may not come overnight, but it is long overdue.