Mother’s Day: State of the World's Mothers, May 11, 2006

An Iraqi woman holds her infant at the al-Alawiyah Hospital in Baghdad. (Photo: Thomas Coex / AFP-Getty Images)

While florists worldwide are preparing to benefit from their second busiest period of the year behind Valentine's Day — the Mother's Day weekend — Save the Children, an international humanitarian organization, is focusing on the 60 million mothers in the developing world who give birth every year with no professional help and their newborns, many of whom struggle to live past their first month of life.

The organization recently released "The State of the World's Mothers 2006" report which lists the best and worst places to be a mom, the causes of maternal and newborn deaths, and low-cost solutions that are saving newborn lives across the globe.

According to the 2006 Mother's Index, the top and bottom ranked places to have a child are as follows:

Top-ranked Countries
United Kingdom
United States

Bottom-ranked Countries
Congo, Democratic Republic of the
Central African Republic
Sierra Leone
Burkina Faso

London's Reuters (May 9) reported on the study's results, noting: "Scandinavian countries sweep the top rankings of the best places to be a mother, while countries in sub-Saharan Africa dominate the bottom tier. The Mothers' Index exposes an enormous disparity between the highest- and lowest-scoring countries and underscores an urgent need to address this divide. For instance, in Sweden, which tops the list, nearly all women are literate. In contrast, only 34 percent of Ethiopian women are literate. And a mother in Ethiopia is 37 times more likely to see her child die in the first year of life than a mother in Sweden."

Some alarming mortality statistics were highlighted by London's BBC (May 9): "More than three million babies are stillborn each year, and about four million die within one month of disease or complications of childbirth. Half of those die on the first day of their lives."

China's Xinhua (May 9) emphasized the fact that mothers were also at risk: "Expectant mothers also fare poorly in undeveloped countries, with half a million women dying annually from complications during pregnancy or birth. A huge number of women give birth at home alone or with no skilled attendant. 'In most of the developing world, childbirth is a dance with death for both mother and baby, even though 70 percent of those deaths could be prevented,' said Anne Tinker, director of the Save the Children's Saving Newborn Lives Initiative. The 50-page report compiles data from the world's nations as well as the World Health Organization and UNICEF and presents a bleak look at the challenges pregnant women and newborns face in impoverished countries, where up to 99 percent of deaths occur."

America's Lackluster Showing

When analyzing the report's findings, one of the topics appearing consistently in the international press was the U.S.'s poor performance.

India's ZeeNews (May 11) pointed out that while most infant deaths occur in developing nations, all is not well in America: "In a sobering message to the world's superpower, the United States has been relegated to the bottom of the pile among industrialized nations with one of the lowest survival rates for newborns."

Germany's (May 9) was more specific: "A recent global study of newborn babies has found America sadly lacking. The United States was found to have a rate of 5 deaths per 1,000 babies. Out of 33 industrialized nations the only country that scored worse was Latvia. The report produced by Save the Children found that overall American health care fell far short of most European countries despite the fact that America spends considerably more per capita than most industrialized countries. Researchers determined that America's poor showing in the study were partly due to a lack of universal health care, short maternity leave, and a severe lack of quality health care for the poor."

In an article preceded by a headline proclaiming, "Death rate tarnishes 'world leader' image," China's People's Daily Online (May 9) noted: "The United States' survival rate for newborn babies ranks near the bottom among developed nations. … Other possible factors in the United States include teen pregnancies and obesity rates, which both disproportionately affect African-American women and also increase risk for premature births and low birth weights. Among U.S. blacks, there are 9 deaths per 1,000 live births, closer to rates in developing nations than to those in the industrialized world.

'Every time I see these kinds of statistics, I'm always amazed to see where the United States is because we are a country that prides itself on having such advanced medical care and developing new technology ... and new approaches to treating illness. But at the same time not everybody has access to those new technologies,' said Dr Mark Schuster, a Rand Company researcher and pediatrician with the University of California, Los Angeles.

"In the United States, about half a million babies are born prematurely each year, data shows. African-American babies are twice as likely as white infants to be premature, to have a low birth weight, and to die at birth."

In the same vein, India's Hindustan Times (May 10) reported: "Of the 33 industrialized nations, the United States is tied with Hungary, Malta, Poland and Slovakia with a death rate of five per 1000 babies. Only Latvia is slightly worse off with a rate of six per 1000."

Also weighing in was Canada's Toronto Star (May 10): "America may be the world's superpower, but its survival rate for newborn babies ranks near the bottom among modern nations, better only than Latvia."

Some Countries Proud Of Ranking

Some countries had a reason to be proud of their ranking. Online (May 10) reported: "Denmark and the other Scandinavian countries were all represented in the top four of Save the Children's annual 'State of the World's Mothers' report. Denmark finished second behind Sweden in the 'Mother's Index', a rating of ten indicators measuring the status of women and children in 125 countries. The Scandinavian countries were highlighted for the health of their women and children, as well as the professional and social status women enjoy. The report pointed out that 37 percent of Denmark's members of parliament were women, far higher than in other Western democracies."

According to The Australian (May 9): "Mothers in Australia have it better than their counterparts in the United States or United Kingdom, a new report shows. Australia has ranked seventh, equal with the Netherlands, while Canada was ninth and the U.S. and U.K. tied for 10th. Indicators of what made a good country for mothers included the lifetime risk of maternal mortality, the number of women using modern contraception and the number of births attended to by skilled personnel."

Canada's Globe and Mail (May 11) struck an appreciative tone: "With Mother's Day just around the corner, Canadian moms can be grateful that their country has been ranked as the ninth best place in the world to be a mother. Canada ranked just ahead of the U.S. and the U.K., but just below Australia and the Netherlands, which tied for seventh. … There are countries that are much worse off than those ranked in the index. Somalia was so low that it wasn't even ranked in the top 125 countries. In that country, more than one in seven children die before their first birthday (by comparison one in 200 children die before their first birthday in Canada). Somalia is equally dangerous for mothers with 10 percent of women dying during childbirth, according to the report. In Canada, 1 in 8,700 women die during childbirth."

MaltaMedia (May 10) reported that: "Malta has a death rate of nearly 5 per 1,000 babies, according to a new report. This figure applies to the United States, Hungary, Poland and Slovakia, with Latvia being slightly higher at 6 per 1,000.In the analysis of global infant mortality, Japan had the lowest newborn death rate at 1.8 per 1,000. The highest rates globally were in Africa and South Asia. Liberia ranked the worst, with a newborn death rate of 65 out of 1,000 live births."

Intimating that there was some room for improvement in their country, the Korea Times (May 10) reported: "South Korea's newborn health index ranked 30th among 167 countries this year, while North Korea came in 70th place, according to a report by Save the Children, a U.S.-based global independent humanitarian organization. Korea's ranking falls way behind that of Japan and the U.S. Japan ranked first with only three out of every 1,000 babies dying before their first birthday while the U.S. ranked fifth. In Korea, every five babies per 1,000 under one year old died this year due to various health problems. Of every 1,000 born in North Korea 42 infants died before their first birthday. The report said China's health index for newborns ranked 91st with 26 out of every 1,000 infants dying before reaching one year."

Suggestions To Improve Mortality Statistics

What should be done to help improve the dismal infant mortality statistics in the developing world? The BBC (May 9) noted that: "Save the Children argued that low-cost interventions could reduce newborn deaths by up to 70 percent. It said Colombia, Mexico, Nicaragua, Vietnam, Eritrea and Tajikistan are among developing nations doing an 'admirable job' in investing in services and education that improve the prospects for mothers and infants, despite limited resources. Such countries improve their prospects for economic growth and development, said the report, which pointed out that babies who receive an unhealthy start in life tend to be sicklier, less productive adults."

France's International Herald Tribune (May 9) weighed in: "…some developing countries that made newborn and maternal health a priority had succeeded in cutting newborn death rates, among them Indonesia, Eritrea, Nicaragua and the Philippines. Parents must also be educated about the importance of breast-feeding, the group recommended, and of not introducing liquids or foods that contain dirty water, which can cause diarrhea. Another element of a strategy to reduce deaths is to give women access to modern contraceptives, the group said. Birth control lets women plan to have children with enough time between births to preserve the mother's health and to reduce the likelihood that their babies are born with low birth weights."

According to The Scotsman (May 9): "Simple, affordable techniques, such as immunizing women against tetanus and providing a skilled attendant at birth, could reduce these deaths by 70 percent, the report said. It also said newborn deaths were so common in many parts of the developing world that parents put off naming their babies until they are between one week and three months old. Save the Children described the large number of newborn deaths as 'one of the world's most neglected health problems' and urged governments around the world to increase political and financial aid to help prevent further deaths. It called for more investment to give young women in poor countries better access to education, nutrition and contraceptives, and for improved used of tetanus immunizations, skilled birth attendants and education about warmth and breastfeeding for infants."

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