During my years as a practicing midwife I witnessed many babies enter the world before they were ready. The most vulnerable time for a child is during birth or within 28 days of birth. And for babies born before 37 weeks, the risks are further heightened by health complications due to underdevelopment of organs, muscles and immune systems.
Prematurity is the biggest killer of children under five, after pneumonia, claiming the lives of more than one million newborns every year.
It's never easy to watch what should be a joyous moment for mothers and their families become a time of fear and sadness. But unfortunately, premature birth is all too common: more than 1 in 10 babies are born too soon, amounting to 15 million preterm births per year. It's a truly global problem. While more than 60 percent of these births occur in South Asia and sub-Saharan Africa, the United States and Brazil also appear among the world's top 10 countries with the highest numbers of premature deliveries.
This is an issue the global community must take seriously in our push towards achieving Millennium Development Goal 4 to reduce child deaths by two thirds. Evidence now shows that fewer children are dying from two major childhood killers, diarrhea and malaria. Yet, there has been very little progress on neonatal causes of under-five mortality. If countries continue to make progress at their current rates, it will take the world much too long to reach MDG 4: the Americas would achieve their target in 2040, Southeast Asia not until 2085 and Africa not until 2165.
Joining governments, NGOs, health professionals, multilateral agencies, donors, private sector organizations and others working towards meaningful change for newborns, The Partnership for Maternal, Newborn & Child Health (PMNCH) is proud to mark November 17 as the second annual World Prematurity Day. This global day of action shows when we all work together, we can become much bigger than the sum of our parts.
The May 2012 launch of Born Too Soon: The Global Action Report on Preterm Birth was a game-changer. The report presented first-ever country-by-country statistics for both absolute numbers and rates of preterm birth, documenting the extent and severity of the problem.
Nearly 50 international, regional and national organizations worked on this report, led by the March of Dimes, PMNCH, Save the Children and the World Health Organization. This collaboration set in motion a global movement to promote progress on preterm birth in support of the Every Woman Every Child effort, led by UN Secretary-General Ban Ki-moon. At the time of the report's launch, 30 new and expanded commitments specific to prevention and care of preterm birth were announced -- commitments that will be tracked every year though 2015 as part of the public accountability framework associated with Every Woman Every Child.
The goals of Every Woman Every Child were reinforced this past June when the governments of Ethiopia, India and the United States convened more than 700 representatives from government, civil society, faith based groups and the private sector to launch a Child Survival Call to Action in Washington, D.C. Signing A Promise Renewed, they reaffirmed concerted action towards ending preventable child mortality, including deaths from preterm-related complications.
Building a coalition of the willing for a neglected yet essential issue like preterm birth is half the battle. If we can remain united in our efforts, and maintain global attention on the need to prioritize preterm prevention and care, we can put what we already know into action to dramatically change the nature of the problem.
Preterm babies face drastically different odds depending on where they are born: 90 percent of preterm babies in low-income countries die, while 90 percent of preterm babies in high-income countries survive. This is a completely unnecessary injustice. More than 75 percent of deaths due to preterm complications could be averted without intensive care.
A common myth about premature birth is that expensive technology is needed to care for high-risk mothers and premature newborns. But the reality is that very basic, low-cost care can prevent tragedy in most cases -- things like keeping babies warm and clean, providing breastfeeding support, while ensuring that babies who have difficulty breathing get immediate attention and resuscitation, if needed. Rapid recognition and treatment of infections with antibiotics is also critical.
Using an essential package of pregnancy, childbirth and postnatal care that includes these interventions, most infants born prematurely can escape death and lifelong disabilities.
Prevention is the next frontier. A key way to reduce the burden of preterm birth is to find ways to help pregnancies go to full term. A number of risk factors for mothers to deliver prematurely have been identified - for instance, poor health or nutrition for women before and during pregnancy, spacing births too close together or too far apart -- but we have much more to learn.
Let's change the face of preterm birth. Help us shine light on this long neglected issue and demand immediate action for communities suffering an unacceptable burden. Every mother who brings a little one into the world prematurely deserves a day to cherish, not mourn. Place of birth should never determine a child's right to life.
This blog is part of a series co-ordinated by the Healthy Newborn Network building momentum for World Prematurity Day, November 17, discussing preterm birth and highlighting the actions needed to prevent and reduce this leading cause of newborn deaths. To get involved and learn more, please visit www.facebook.com/WorldPrematurityDay.