Collateral Damage

We've heard about the baby boom (reduced access to family planning resources) and the baby bust (can we afford to bring a child into the new world?), each of which might have an impact on the size and character of the population of the new world.  Now Nature brings us the story of stillbirths, from a survey of 20,000 women who gave birth in nine hospitals in Nepal.  It seems that in this population, between March and May, stillbirths increased by 50%.  The same result - increase in stillbirths of around 50% - was found in a study of four Indian hospitals, between March and June.*

In England, a similar study found that stillbirths increased fourfold.  There may be an uptick in Scotland, as well. 

There is some confusion about the numbers, at least in Nepal and India, involving percentages, absolute numbers, and lack of data. The basic issue is that women did not come in to their medical providers for regular or emergency visits at anywhere near the normal rate, and the number of women who gave birth in hospitals fell by half in Nepal - while the number of stillbirths recorded in hospitals remained the same.  What happened to the half of women who normally would give birth in a hospital but, during the lockdown, did not?  That's the "lack of data" part.  No one knows.

I find it chilling to think of mothers - millions of them? - who were unable or unwilling to go into a dangerous world to get essential care and resources which would lead to a healthy birth.  And the fact that after they fell off the radar, their access to these resources was gone.  How many complications led to how many tragic disasters?  How many empty cradles around the world?  We don't know.

Asma Khalil, an obstetrician involved in the English study, calls these findings "the collateral damage of the pandemic."  Indeed. 

* - The original study in Nepal is here; the Indian study (both in The Lancet), is here..  The original English study, in JAMA, is here.