An estimated 2.8 million pregnant women and newborns die every year, or 1 every 11 seconds, mostly of preventable causes, according to new mortality estimates released by UNICEF, the World Health Organization (WHO), the United Nations Population Division, UNFPA and the World Bank Group.
For mothers and their babies, the period surrounding birth is a particularly vulnerable time. For mothers, complications leading to maternal death can occur without warning at any time during pregnancy and childbirth. In 2017, according to the latest estimates, over 800 women died each day from complications in pregnancy and childbirth, or over 290,000.
Likewise, for newborns, the first 28 days of life – the neonatal period –are critical for a child’s survival. Children face the highest risk of dying in their first month of life. In 2018, 7,000 newborn babies died every day. About a third died on the day they were born and nearly three quarters in the first week alone. According to the latest estimates on child mortality, newborns accounted for around half of the 5.3 million under-five child deaths in 2018.
“Around the world, birth is a joyous occasion. Yet, every 11 seconds, a birth is a family tragedy,” said Henrietta Fore, UNICEF Executive Director. “A skilled pair of hands to help mothers and newborns around the time of birth, along with clean water, adequate nutrition, basic medicines and vaccines, can make the difference between life and death. We must do all it takes to invest in universal health coverage to save these precious lives.”
The following provides more information on how mothers and newborn babies are most vulnerable during child birth, and other key takeaways from the latest update of the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME):
1. Neonatal mortality is declining at a slower rate than under-five mortality: Globally, the average annual rate of reduction in the neonatal mortality rate was 2.6 per cent from 1990 to 2018, compared to 3.6 for older children under five years. Across all regions, the annual rate of reduction from 1990 to 2018 was higher for children aged 1–59 months than for newborns.
2. Great inequities persist between countries: In sub-Saharan Africa, levels of maternal deaths are nearly 50 times higher for women and their babies are 10 times more likely to die in their first month of life, compared to high-income countries, the estimates show.
3. Sub-Saharan Africa is lagging behind: Sub-Saharan Africa had the highest neonatal mortality rate in 2018 at 28 deaths per 1,000 live births, followed by Central and Southern Asia with 25 deaths per 1,000 live births. The risk of dying for a newborn in sub-Saharan Africa is about 33 times higher than in the lowest mortality country. A sub-Saharan African woman faces a 1 in 37 life time risk of dying during pregnancy or childbirth.
4. Newborn deaths often account for a larger share of under-five deaths at lower under-five mortality levels: In Europe and Northern America, which has one of the lowest under-five mortality rates among all regions, 54 per cent of all under-five deaths occur during the neonatal period.
5. Most newborns and pregnant women die due to preventable and treatable reasons: Newborns die largely because they are born too soon or too small, have complications during birth or congenital defects, or contract tetanus or sepsis. Most children under 5 die due to preventable or treatable causes – such as complications during birth, premature birth, pneumonia, diarrhea and neonatal sepsis. Maternal deaths are caused by obstetric complications such as high blood pressure during pregnancy and severe bleeding or infections during or after childbirth; and increasingly due to an existing disease or condition aggravated by the effects of pregnancy.
6. In total, almost 6.2 million children under 15 died in 2018: Globally, 85 per cent of deaths among children and young adolescents in 2018 occurred in the first five years of life. 2.5 million occurred in the first month of life, and four million in the first year. Another 1.3 million occurred between ages 1 and 4 and an additional 0.9 million deaths occurred among children aged 5−14 years.
7. Progress is possible: Since 1990, there has been a 56 per cent reduction in deaths of children under 15 years from 14.2 million deaths to 6.2 million in 2018. Countries in Eastern and South-East Asia have made the most progress, with an 80 per cent decline in under-five deaths. And from 2000 to 2017, maternal mortality ratio declined by 38 per cent.
8. We need to act now: Unless we act now, 62 million children under age 15 will die between 2019 and 2030, including 52 million children under 5. Almost half of these under-five deaths will be among newborns.
Through its global campaign, Every Child ALIVE, which demands solutions on behalf of the world’s newborns, UNICEF urges governments, the private sector and civil society to:
• Increase funding and awareness particularly in areas that will improve newborn and maternal health and address key killers of children such as pneumonia and diarrhea;
• Develop the skills of health workers and ensure they have the equipment to provide high quality care that meets the health needs of women, newborns;
• Invest in primary health care, including the strengthening of health systems;
• Guarantee clean, functional health facilities equipped with water, soap and electricity, within the reach of every mother and baby;
• Empower adolescent girls, mothers and families to demand and receive quality care.
