“It shattered me when I heard that the baby had already died in my womb,” says sombre Muneera Khatoon, a maid who works in different homes. While sharing her agony, she says that she had been feeling pain during the night to which she paid no heed as there was only one more month left until her delivery. But as the intensity of the pain increased in the morning she decided to go to the hospital where it was revealed that her baby had died.

Muneera’s case is not a singular one; according to a report published in the Lancet, worldwide more than 2.6 million pregnancies a year end in stillbirth. The World Health Organisation (WHO) defines stillbirth as a child lost after 28 weeks of gestation or during the third trimester of pregnancy.

Countries with the highest stillbirth rates are: India, Pakistan, Nigeria, China, Bangladesh, the Democratic Republic of Congo, Ethiopia, Indonesia, Afghanistan and Tanzania. Pakistan ranks second with a rate of 47 stillbirths per 1,000 pregnancies.

According to the report, 98 per cent stillbirths occur in countries of low and middle income. The significant point is to see whether the problem lies with the mother or the foetus. Hence, it is important to have monthly prenatal check-ups through which you can avoid these situations. The major reasons include complications in childbirth, maternal infections during pregnancy (e.g. syphilis), maternal under-nutrition and foetal growth restriction, and congenital abnormalities. If an expecting woman has problems like anaemia, diabetes or hypertension this may prove to be a precursor to complications at the time of birth. Moreover, the risk of stillbirth also increases if the mother is over-weight and obese, smokes, is above the age of 40 and has had multiple pregnancies.

Most of these complications can be averted if proper medical care is provided to mothers. Consultant Gynaecologist, Dr Kaneez Fatima, says that the financial burden has broken the backbone of the poor. Though it is important to have monthly checkups, inflation and increasing poverty have made it difficult for the poor to bear the expenses of regular checkups.

Muneera Khatoon did not have the money to buy the medicines or supplements prescribed by her physician. She would have three meals a day, though this was not sufficient nutrition to facilitate the growth of her baby.

Clinical Nutritionist, Ifra Nawab, believes that people who are disadvantaged often suffer from malnutrition and this may result in complications at the time of birth. They cannot have regular check-ups as this would cost them heavily; they are unable to take the supplements and medicines prescribed by doctors. Therefore, to counter this they should take food that is more nutritious, like Semolina (Sooji) which is a source of protein and chicken liver, and is cost-effective. Tomato salad is also good and one can sprinkle some salt onto it to help balance potassium level. Coconut water is also a good source of potassium that may stabilise heart beat during delivery. Furthermore, folic acid and calcium intake is important for pregnant women.

According to Nawab, the reasons for pregnant women gaining weight are over-consumption of junk food, cold drinks and sweetened juices, and not working out. They need to walk to keep their muscles working. She adds that to satisfy craving instead of eating salty chips or biscuits and using Chinese salt that increases blood pressure, it is appropriate to include fruits, green leafy vegetables, sugarcane juice and milk in their diet.

A balanced diet and healthy lifestyle is the key to a better life. One should avoid smoking and eat properly washed vegetables and properly cooked food.

Consultant Gynaecologist, Dr Anjum Afsha, is of the opinion that not only monetary but social issues are also responsible for negligence during pregnancy. She divulges that often even educated women and those for whom money is not a problem do not come for regular antenatal visits. They do not do so because the in-laws do not feel the need for it saying that they have also borne children and that there’s no need to go to the doctor so frequently. At times, the woman also cannot visit the physician as she is short of time due to work or a busy schedule.

Children are considered to be a blessing. However, when after months of excitement, one hears the heart-wrenching news about the child having died because of mishap before or during delivery, it is truly devastating. To avoid this, proper prenatal and intra-natal care is vital. As the saying goes, ‘prevention is better than cure’.