Bihar is preparing to roll out the Centre's new guidelines on stillbirth surveillance and response and will implement them through portal-based reporting across its health facilities.
Under the guidelines, a stillbirth is a baby born with no signs of life at 28 weeks or more of gestation. Where gestational age is missing, a birth weight of 1,000 grams or more, or a body length of 35 cm or more, applies.
According to health experts, no robust system existed to record stillbirths and their causes until now. Bihar’s stillbirth rate varies across official estimates, ranging from 2 to 4 per 1,000 births in Sample Registration System (SRS) reports for 2022–24.
The SRS 2022 report put the rate at 3, against the national average of 5 per 1,000 births. In 2023, Bihar recorded 4 compared with the national rate of 7, while the 2024 report showed Bihar’s rate falling to 2, against the national average of 7.
However, the state’s Health Management Information System (HMIS) puts the rate at 9 per 1,000 births, while data evaluated by different third-party agencies places it at around 11, close to the national estimate of 11.8 reported by the UN Inter-agency Group for Child Mortality Estimation in 2023.
Health experts in Bihar say the state and Uttar Pradesh together account for 30% of stillbirths in India. The Sustainable Development Goals call for a single-digit national rate by 2030.
So far, reporting stillbirth has been restricted to penning down numbers in hospital records. However, as part of a national effort to reduce the stillbirth rate, the Centre has worked out a robust reporting mechanism.
About the new system
Stillbirth reporting will now be done on the maternal, perinatal, child death surveillance and response (MPCDSR) portal. The facility nodal officer must report every case within 24 hours. The doctor, nurse, or auxiliary nurse midwife (ANM) who conducted the delivery must complete the reporting form within 7 days or before the mother is discharged.
A data entry operator then uploads the details to the portal, in accordance with the new reporting guidelines, officials said.
Each entry will capture the number of stillbirths, the timing, and the cause, as defined by the International Classification of Diseases (ICD). An ICD medical report uses standardised alphanumeric codes published by the World Health Organisation to classify diagnoses, symptoms, injuries, and medical procedures. It provides a universal language for doctors and nurses to document health conditions accurately.
Causes of stillbirth will be marked antenatal (occurring during pregnancy, before the birth of a child), maternal (a condition related to the mother), or intrapartum (occurring during the act of labour and childbirth). A review and a brief case history of the patient also has to be mentioned on the portal, said experts..
Health facilities will review cases every month. Districts will take them up during monthly meetings, and the state will examine selected cases every quarter. Specialist facilities will submit detailed data, while peripheral centres will report a smaller set of parameters.
High-risk pregnancies, anaemia, malnutrition and other medical conditions in expectant women are among the leading causes of stillbirth. The guidelines also point to poor antenatal care, hypertension, diabetes, infections and delays in reaching hospitals during labour pain. About 40% of stillbirths occur during labour, experts said.
In Bihar, 11% of the average 37 lakh pregnancies each year are high-risk. Early marriage is cited as a driver. The share of women aged 15 to 19 who are married edged up from 11% in the National Family Health Survey (NFHS)-5 to 11.4% in NFHS-6. NFHS-6 data pertain to 2023-24 (with fieldwork conducted from May 2023 to December 2024), and the national and state/UT fact sheets were released on May 29, 2026.
The state, on its part, collaborated with the Indian Council of Medical Research (ICMR), AIIMS Patna and UNICEF and initiated an implementation research in Purnia in October 2024 to achieve single-digit neonatal mortality (the number of deaths during the first 28 days of life per 1,000 live births) under ‘Project Sankalp’. It examined causes, capacity gaps, case recording, and protocol-based reviews. It is now being carried out in all districts of Bihar, officials said.
Official efforts
The Union health ministry, Bihar State Health Society and UNICEF organised a two-day workshop on October 8-9 in Patna, in which resource persons from the Centre trained 20 master trainers each from Bihar and Jharkhand.
Dr Shobhna Gupta, deputy commissioner for child health at the Ministry of Health and Family Welfare (MoH&FW), and Dr Nande Putta, chief of health at UNICEF India, participated online. Dr Siddhartha Reddy, health specialist from UNICEF Bihar, deliberated on the rollout of the latest national stillbirth response and review guideline.
Stressing the state’s resolve to reduce stillbirths, Bihar health secretary Kumar Ravi told Hindustan Times: "Several deep-rooted issues causing stillbirths have been identified, and a protocol for them has been prescribed. The state health department will follow the protocol issued by the government of India in collaboration with expert partners, and is ready to put to use the new guidelines and portal-based reporting across health facilities.”
“In our endeavour to effectively reduce stillbirths, we recently held a two-day workshop organised by the MoHFW and UNICEF. It was a training programme of trainers in which doctors nominated from Bihar and Jharkhand joined,” Ravi added.