WESTPORT, Conn. (Feb. 24, 2014) — The first 24 hours of a child's life are the most dangerous, with more than one million babies dying each year on their first and only day of life, according to new research published today by Save the Children.
The new report, "Ending Newborn Deaths," shows one half of first day deaths around the world could be prevented if the mother and baby had access to free health care and a skilled midwife. Learn More.
The children's aid agency says the deaths happen because of premature birth and complications during birth, such as prolonged labor, pre-eclampsia and infection, which can be avoided if quality health experts are present.
The research also found an additional 1.2 million babies are stillborn each year, their heartbeats stopping during labor because of childbirth complications, maternal infections and hypertension.
In a bid to save millions of newborn lives, Save the Children has called on world leaders to commit in 2014 to a blueprint for change – The Five Point Newborn Promise – which focuses on training and equipping enough skilled health workers to make sure no baby is born without proper help, and removing fees for all pregnancy and birth services.
Gbassay, 22, holds her 1-week-old baby boy Brima. Gbassay gave birth at the side of the road, at night, en route to Massam maternity child health post. Photo by Jordi Matas/Save the Children
The world has made amazing progress in reducing child mortality during the past decade – nearly halved from 12 million to 6.6 million – thanks to global political action on immunisation, treatment of pneumonia, diarrhoea, and malaria, family planning and nutrition.
But this progress could stall without urgent action to tackle scandalously high numbers of newborns dying. This report warns that newborn deaths now account for nearly half of all under-five deaths.
Carolyn Miles, President and CEO of Save the Children, said:
"The first day of a child's life is the most dangerous, and too many mothers give birth alone on the floor of their home or in the bush without any life-saving help. We hear horror stories of mothers walking for hours during labor to find trained help, all too often ending in tragedy.
"It's criminal that many of these deaths could be averted simply if there was someone on hand to make sure the birth took place safely and who knew what to do in a crisis."
Sophie *, 38, and her newborn baby delivered through cesarian operation in Bouar hospital, Central African Republic (* name changed to protect identity). Photo by Greg Funnell for Save the Children.
Each year, 40 million women give birth without trained help. In Ethiopia, only 10 percent of births have skilled help whereas in some areas of rural Afghanistan there is just one midwife for 10,000 people.
In countries such as the Democratic Republic of Congo (DRC) or the Central African Republic (CAR), some mothers have to pay for emergency maternal care, often costing as much as their monthly food bill. There have even been reports of mothers being kept under jail-like conditions for months until they have been able to pay for their emergency caesarean.
Carolyn Miles added: "These new statistics reveal – for the first time ever – the true scale of the newborn crisis. The solutions are well-known but need greater political will to give babies a fighting chance of reaching their second day of life. Without targeted action now, progress made in cutting child mortality through vaccines and tackling malnutrition will stall."
Save the Children is calling on world leaders, philanthropists and the private sector to meet and commit to the Five Point Newborn Promise in 2014:
Issue a defining and accountable declaration to end all preventable newborn mortality, saving 2 million newborn lives a year and stopping the 1.2 million stillbirths during labor
Ensure that by 2025 every birth is attended by trained and equipped health workers who can deliver essential newborn health interventions
Increase expenditure on health to at least the WHO minimum of US$60 per person
To pay for the training, equipping and support of health workers, and remove user fees for all maternal, newborn and child health services, including emergency obstetric care
The private sector, including pharmaceutical companies, should help address unmet needs by developing innovative solutions and increasing availability for the poorest to new and existing products for maternal, newborn and child health.
Save the Childrenis the leading, independent organization that creates lasting change for children in need in the United States and around the world. Follow us onand .
Notes to Editors
In 2012, 1.013 million babies died on their first day. This is from joint research carried out by Save the Children and Joy Lawn due to be released in a forthcoming Lancet Global Health article - to be published in May 2014.
Save the Children is supporting the development of a global plan to reduce newborn deaths called the 'Every Newborn Action Plan' (ENAP). This plan calls for a two-thirds reduction in newborn deaths. In 2012, there were 2.9 million newborn deaths. If the ENAP target of a two-thirds reduction had been achieved in 2012, approximately 2 million newborn lives could have been saved. Identifying what proportion of first day deaths could be prevented is harder, but the draft 'Every Newborn Action Plan' shows that "Skilled care during labor and childbirth with prompt management of complications alone can prevent about 50 percent of newborn mortality and 45 percent of intra-partum stillbirths." These are in effect first day deaths and therefore we can say that half would be prevented.
The "State of the World's Midwifery" in 2011 (UNFA) describes intrapartum stillbirth as fetal death after the onset of labor. Intrapartum stillbirth rate based on: Lawn JE, Blencowe H, Pattinson R, et al. "Stillbirths: Where? When? Why? How to make the data count?" Lancet 2011; 377(9775): 1448-63. http://www.thelancet.com/series/stillbirth. Total number of intrapartum stillbirths is updated to 2012 using live births and total births from UN Pop Div latest estimates. Stillbirth refers to a baby born with no signs of life at or after 28 weeks (6 months) of pregnancy. In 2009, there were 2.6 million stillbirths worldwide. In our report, we highlight the fact that 45 percent of these stillbirths – 1.2 million – occurred during labor and childbirth, i.e. Intrapartum. This means that the child's heart was beating before the process of labor began, but stopped during labor or delivery.
Of the 6.6 million children under-five who died in 2012, almost half – 2.9 million – died within the first 28 days of being born, the newborn period. Reference: United Nations Inter-agency Group for Child Mortality Estimation. Levels and trends in child mortality: Report 2013. New York, USA: UNICEF, 2013. http://www.childinfo.org/files/Child_Mortality_Report_2013.pdf.
Calculated as the number of births not attended by skilled health personnel. SBA coverage based on data from the WHO Global Health Observatory. Number of live births based on data from State of the World's Children statistics.
7. We have used the most up to date statistics where possible. The number of midwives in Afghanistan was taken from 2010 http://data.worldbank.org/indicator/SH.MED.NUMW.P3 and the number of births attended in Ethiopia was taken from the 2011 Global Health Observatory.
Calculation on how to save 2m lives a year see reference 2