The latest government data on perinatal deaths paints a worrying picture of SA’s maternal care, with the number of stillbirths recorded by Stats SA more than doubling from 1997 to 2020.
The number of babies who died in the womb — either before or during delivery — reached 15,908 in 2020, down slightly from 16,187 the previous year. SA defines a stillbirth as a foetus of at least 26 weeks which showed no signs of life at birth.
By far the most common cause of such deaths was complications related to pregnancy, labour and delivery, highlighting “the critical need for improved maternal and neonatal healthcare”, said Stats SA.
Early neonatal deaths, which occur within the first week of life, also remained a “significant concern”. The number of babies who died within seven days of birth rose from just more than 7,000 in 1997 to 8,200 in 2020.
The data shows that infant mortality risks are at their highest within the first few days of birth. Nearly a third of neonatal deaths took place on the day of birth, while 68% happened within the first three days.
“The first few days after birth remain the most critical,” said Stats SA. Notably, only 4% of all stillbirths and neonatal deaths took place in homes, with about 70% recorded in hospitals.
While the primary cause of stillbirths was pregnancy and labour complications, early neonatal deaths were most commonly associated with respiratory and cardiovascular issues, followed by nervous, circulatory and musculoskeletal system malformations.
For both stillbirths and early neonatal deaths, boys were consistently more vulnerable than girls across the reporting period.
This data is “essential for informed decision-making and for improving healthcare services for mothers and newborns”, said Stats SA. Understanding the distinction between stillbirths and early neonatal deaths is “crucial for assessing maternal and newborn health outcomes and improving healthcare interventions”.
While the data shows a concerning trend, a recent report by the UN Children’s Fund (Unicef) highlighted SA’s “extraordinary progress” in combating child mortality.
The report showed that deaths of children below the age of five has fallen from 7.9% of live births in 2004 to 3.2% in 2018, driven primarily by the prevention of HIV transmission between mothers and their offspring.
However, SA’s under-five mortality rate is still about three times greater than other middle-income countries, with young children continuing to die of preventable causes, such as neonatal conditions, diarrhoea, pneumonia and injuries.
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