The NGO Save the Children has released its annual “Mother’s Day Rankings,” categorizing the best and worse places for mothers around the world.
The U.S., unsurprisingly, is one of the best places in the world – we ranked 11 out of 117. But, considering our vast wealth, it’s disappointing that we didn’t rank first (or even rank in the top ten).
One major reason the U.S. isn’t ranked higher is our terrible health care system: too many American women die in pregnancy or childbirth, and our infant mortality rate is too high. (The other reason is that the U.S. falls far behind other industrialized countries when it comes to women in national government; 14% of congress is female, compared to 45% in Sweden, which was the country ranked #1 by Save the Children). In the U.S., the lifetime risk of maternal mortality is 1 in 3500, compared to 1 in 6000 in Sweden. The U.S. infant morality rate is 7 deaths per 1000 live births, compared to 3 in 1000 in Sweden.
Dawn Olsen has written an excellent post about the Save the Children report and U.S. health care – go check it out.
How likely you are to die in birth – or childbirth – in the U.S. depends on race. According to the CDC, the U.S. infant mortality rate for whites is 5.7 per 1000, a rate comparable to Switzerland or Australia. The U.S. infant mortality rate for blacks is 14 per 1000, a rate comparable to Uruguay and Bulgaria. The differences in maternal mortality rates are even more stark – 5.5 per 100,000 for whites, compared to 23.3 per 100,000 for blacks. This means that as far as maternal mortality is concerned, American whites have nearly the best health care in the world – better than Sweden’s – while American blacks might as well be living in Bulgaria or Saudi Arabia. (I’m using 1995 World Health Organization data, available in word format here, to make this comparison).
In effect, measured by their access to high-quality health care, blacks in the US are living in a “developing nation,” not an “industrialized nation.”
Save the Children’s main point isn’t to compare the US to other countries, but to demonstrate how bad off mothers in developing countries can be. From the WEnews report:
The report is correct to link mother’s and children’s well-being; improving women’s status is the surest route to improving infant (and mother) health. Again from WEnews:
As contraceptive use rises, and mothers are able to space their births at healthy intervals, death among mothers and children declines. For example, in the United Kingdom, where 82 percent of women used modern birth control, only 1 in 5,100 mothers die in childbirth and only 6 out of 1,000 infants did not live to their first birthday. In Guinea, where 4 percent of women used birth control, 1 in 7 mothers died in childbirth and more than 1 in 10 infants died in their first year.
The Save the Children report recommends increased international funding to improve women’s status in developing countries (both by providing economic opportunities and by increasing education for women and girls), and to make maternal and child health care – including “voluntary family planning services” – more available.
These should also be important guidelines in the U.S.’s “reconstruction” of Iraq and Afghanistan (remember Afghanistan?).