Stillbirth rate soars in Nepal during COVID-19 lockdown
Alok Gupta

Nepal witnessed a dramatic rise in the number of stillbirths during the "strict" lockdown, said a new study published Monday.

The stillbirth rate – loss of babies due to miscarriages or death during delivery – in the country shot up by 50 percent to 21 per 1,000 total births. A sharp increase from 14 per 1,000 total births before the lockdown.

The number of births at the hospitals, maternity centers and other medical facilities dropped by nearly half or 49 percent. Worst enough, inequality by ethnicity played a major role in accessing the health services during the lockdown, said the study published in The Lancet Global Health. 

"The COVID-19 outbreak has brought unprecedented disruptions to health services, with the risk being highest in resource-limited countries, and to the most vulnerable," said co-senior author Professor Joy Lawn. 

"Babies can die in minutes if there are delays for safe care," said Lawn. 

As lockdown disrupted essential services, the risk of neonatal death increased more than three-fold, from 13 per 1,000 live births to 40 per 1,000 live births during the lockdown.

When the first case of the new coronavirus was detected on January 23, Nepal tried to prevent transmission through various measures. But as the cases spiraled, disrupting health services, a countrywide lockdown was enforced on March 21 and partially ended in July. 

Travel restrictions had a significant impact on women and babies. Fear of going to hospitals due to COVID-19, with more complex cases in facilities, resulted in delays and reduced quality of care, Lawn added. 

At risk of missing health goals

In an effort to reach the sustainable development goal (SDG) of ending preventable deaths by 2030, Nepal revamped its national health policy. As a result, over the last three decades, the country has reduced maternal mortality by 76 percent and newborn mortality by 62 percent. 

The stillbirth rate in the country was 18 per 1,000 live births in 2015 as institutional deliveries became one of the major challenges for the country. But in recent years, policy changes helped increase the facilities to expecting mothers to 60 percent, a three-fold increase from barely 18 percent in 2006. 

The strict lockdown wreaking havoc on maternal and neonatal care has prompted health experts to question the logic behind such decisions. "Future progress is now threatened, and each day lives are at risk," researchers warned. 

Collateral effects of such lockdown, Lawn said, have been much more severe than the actual direct effects of COVID-19, especially for the most vulnerable in our society, pregnant women and babies.

Researchers used data from 22,000 births from nine hospitals in seven provinces of Nepal. The time period covered 12.5 weeks before the national lockdown and 9.5 weeks during the lockdown.