Intrapartum or fresh stillbirth rate

Number of stillbirths per 1000 births (live and stillbirths).

Stillbirths can occur antepartum or intrapartum. In many cases, stillbirths reflect inadequacies in antenatal care coverage or in intrapartum care. For purposes of international comparison, stillbirths are defined as third trimester fetal deaths (≥ 1000 g or ≥28 weeks).


Number of stillborn infants.


Number of births (dead or alive).



Data from civil registration: the number of stillbirths divided by the number of total births.

Data from surveys: the number of pregnancy losses during or after the seventh month of pregnancy for the 5 years preceding the interview, divided by the sum of live births and late pregnancy losses in the same time period.

Data from administrative reporting systems/registries: the number of stillbirths divided by the number of total births.

Data from health facilities: the number of stillbirths divided by the number of total births documented in the facility.

For data from countries with civil registration and good coverage, data meeting definition criteria of greater than or equal to 1000 g or 28 completed weeks gestation are taken directly from civil registration without adjustment. For other countries, stillbirth rates are estimated with a regression model.


Civil registration and vital statistics system, population-based surveys.

Administrative reporting systems, health facility assessments, admission and labor ward registry, partographs, and special studies.


Ideally, intrapartum stillbirth serves as an indicator of the quality of intrapartum care and should include all fetuses weighing 1000 g or more or after 28 weeks of gestation. The indicator is based on the WHO recommended birthweight cut-off for international comparison since setting a birthweight cut-off of 1500 or 2000 g would negatively affect recording of data on stillbirths. 


Few countries have sufficiently developed vital registration systems that can provide valid and reliable information on all births and deaths in the community. Health information systems can only provide information on births and deaths in facilities and, in most settings, are not well developed.Furthermore, decision-making for low birthweight and short gestational age categories depends on the availability of resources: personnel are reluctant to intervene for the sake of the fetus when resources are limited. 


Labor and delivery, Intrapartum care, Inpatient care, Maternal health, Mortality

World Health Organization (WHO). 2015 Global Reference List of 100 Core Health Indicators.; 2015. http://apps.who.int/iris/bitstream/10665/173589/1/WHO_HIS_HSI_2015.3_eng.pdf

World Health Organization (WHO). Consultation on Improving Measurement of the Quality of Maternal, Newborn and Child Care in Health Facilities.; 2013. http://apps.who.int/iris/bitstream/10665/128206/1/9789241507417_eng.pdf

 

Further information and related links

Every newborn: an action plan to end preventable deaths. Geneva: World Health Organization; 2014 (Retrieved from http://www.everynewborn.org/Documents/Full-action-plan-EN.pdf).

World health statistics 2014. Geneva: World Health Organization; 2014 (Retrieved from http://apps.who.int/iris/bitstream/10665/112738/1/9789240692671_eng.pdf?ua=1).