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Over the past century in the UK, there has been a dramatic decrease in maternal mortality, attributed to improvements in obstetric care as well as social and living conditions. This has not been matched by an equivalent decline in stillbirths and neonatal mortality as comparative death rates show (figure 1). Intrapartum stillbirths and early neonatal deaths occurring as a consequence of events during labour are thought to be largely preventable with high-quality labour care in high-resource settings.1 2 However, the majority of stillborn babies die in the antepartum period, when prevention through better obstetric care is more challenging. Concerns have been expressed that current actions to prevent intrapartum stillbirths and neonatal deaths are simply ‘shifting the problem’, that is, babies who previously would have died either during labour or shortly after birth are those who are now born and survive with brain injuries and their subsequent long-term consequences. In England, this led the government to introduce, alongside a national ambition to halve the number of stillbirths and neonatal deaths, an ambition to halve the number of brain injuries occurring during or soon after birth by 2030.
Although there are some variations in the gestational and birth weight limitations used, defining and counting …
Contributors MK drafted the manuscript.
Competing interests MK reports she was a member of the group that produced the consensus definition of brain injuries during or shortly after birth.
Provenance and peer review Commissioned; internally peer reviewed.