The best and worse countries for mothers & children

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:

Compared with a mother in the top 10 countries, a mother in the bottom 10 countries is 27 times more likely to see her child die in the first year of life and 600 times more likely to die in pregnancy or childbirth. In the bottom 100 countries, nearly 4 out of 7 children are not attending school, and only 1 in 4 adult women is literate. In the top 10 countries, virtually all children go to school and all women are literate. For example, in Sweden, 99 percent of women are literate while at the other end of the scale, only 8 percent of women in Niger are literate.

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:

The study found that a mother’s level of education and her access to family planning services were the most important factors linked to infant survival and well-being. Women who are educated are more likely to postpone marriage and early childbirth, seek health care for themselves and their families and encourage all of the children, including girls, to go to school.

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?).

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14 Responses to The best and worse countries for mothers & children

  1. 1
    sarah says:

    Yes, I believe that the treatment of both women and children are based a lot on race. This is because there is so much racism in this world, and sadly, we can’t really do anything to make it go away.

  2. 2
    john says:

    to sarah-


  3. 3
    Thierry Wasserman says:

    The ranking seems a little meaningless as a lot of countries are missing from the list. I first looked at the places I’m from, Belgium and Israel, and they’re not there. France? Spain? Portugal? Nope. Therefore looking at the ranking seems useless. The data itself is pretty interesting; Particularly the relative high mortality and low contraceptive use in the states.

  4. 4
    Jackie says:

    I am interested in knowing the 4 best and the 4 worse countries in the world.

    Thank you for all the good and valuable information.


  5. 5
    quality kingdom says:

    I agree!! Thank you for all the good and valuable information. It has been very helpful. Keep up the good work!

  6. 6
    Jackie Bhagat says:

    I would like to know which are the 4 worse and the 4 best countries in the world to live in.

  7. 7
    Jackie Bhagat says:

    I would like to know which are the 4 worse and the 4 best countries in the world to live in.

  8. 8
    Jackie Bhagat says:

    I would like to know which are the 4 worse and the 4 best countries in the world to live in.

  9. 9
    Jackie Bhagat says:

    I would like to know which are the 4 worse and the 4 best countries in the world to live in.

  10. 10
    Jackie Bhagat says:

    I would like to know which are the 4 worse and the 4 best countries in the world to live in.

  11. 11
    Phyllis Scott Ajisafe says:

    I agree with the author of the report on a personal level as I am the mother of three deceased infants: in 1982, 8.5 months gestation stillborn twins and four years later a daughter delivered by C-section who lived 19 hours. Was everything done to save them? I am black; my doctors were white–I think not. When one twin (Baby B) died shy of 2 weeks due date, the obstetrician refused to deliver the viable twin. Feeling doomed, we tried desperately to get another doctor to intervene–not knowing why Baby B died–however, the next day, Baby A’s heart was no longer beating. Was race a factor in the medical inattention I was receiving? I was made to carry them until delivery which occurred on their due date two weeks later. It was a strange bit of irony to learn that doctors of a same community will not intercede. And all are loathe to testify against each other in court. There’s more. Days after delivery, and back at home I suffered a postpartum hemorrhage and nearly died. I believe–because the obstetrician left afterbirth in my womb. But the hospital lab analysis wouldn’t attest to that. You know the adage “they tend to bury their mistakes.” I did not get immediate attention because my doctor was on a fishing trip. I was in the hospital but no other doctor would perform the D&C to stop my bleeding. I could have bled to death but…they were going to wait for my doctor. I know–it’s unbelievable.
    After awhile the nurses on the floor stopped coming to my room to change the padding that was soaked with blood. They left pads with my mother and my husband and we were basically on our own. I wasn’t in the bushes! I was in a catholic hospital in Upper Montclair, NJ! Four years later with the advantages of a bit more money and better insurance didn’t make a difference as to life or death of my next baby. I had a team of high risk pregnancy doctors (all white). I lived in a predominately white upper middle class New Jersey community which boasted one the best neonatal units in the country. Yet, when my premmie was in trouble, they couldn’t save her, though their reputation was sterling. They came to my bed with “we did everything we could.” But we’re not in Nigeria! my heart railed. Or even Newark (NJ) where infant mortality is so high…its repeatedly reported in the newspapers and requires medical investigations. And we weren’t in the “boondocks” as I had been assured over and over. Yet they gave my baby a blood transfusion which, in the absence of my husband, they pressured me to sign the permission form after ascertaining where or not I was lucid following my c-section. What year is this? Who is the President? they asked and I supposed I answered correctly. They said they needed to do it to save her life. Not many hours later, my sweet, defenseless baby was dead. A year later, my OBGYN, who had diagnosed my second pregnancy and sent me to the specialists said my baby probably died from shock; that her tiny system couldn’t withstand the blood transfusion. Twenty years later, I still don’t understand what the blood transfusion was for. I remember a foreign pediatrician coming to my room (I believe she was from India) saying to me that my baby’s lungs were too small to breathe on her own. But she was hooked up to breathing tubes. She was in an incubator. I still wonder why they didn’t wait for my husband to sign that permission slip. He was after all on his way back to the hospital. Not that I’m a pushover, but he was from Nigeria and suspicious of Americans and would have insisted on a full medical explanation. Pros and Cons. And if he was not satisfied with answers, the procedure would not have happened. Let the chips fall where they may. No matter what I thought. He was obstinate that way.

    So, if we had been a white couple, would they have waited and discussed the blood transfusion with both of us?

    So, is the treatment of mothers and children in America based on race? I’m the wrong mother to ask. I’ll let the infant mortality data stand on its own merit.

  12. Pingback: Alas, a blog » Blog Archive » Roe v Wade and Infanticide

  13. 12
    Radfem says:

    So, is the treatment of mothers and children in America based on race? I’m the wrong mother to ask. I’ll let the infant mortality data stand on its own merit.

    The data does stand on its own. It’s appalling.

    I don’t know what we can do about racism in other countries, but we could do more in the U.S.

    Phyllis, I’m sorry you went through what you did.

  14. 13
    Mendy says:

    Phyllis, I’m sorry that you had to go through that.