Mamas on Bedrest: The Best and Worst Countries for Mamas

May 11th, 2012

A lot of mamas are still dying in childbirth globally and many children won’t see their first birthdays. It’s a shocking truth. While watching the Newshour on PBS the other evening they had a report on the best and worst countries for moms. I already know a lot of this information, but I love to listen to reports and glean whatever new information that I can. Reporter Gwen Ifill interviewed Carolyn Miles, President of the non-profit organization Save the Children and Ms. Miles provided some really good nuggets of information that I’ll share and summarize.

At the top of the list is Norway, which has one of the highest rates of contraceptive use in the world and one of the most generous maternity-leave policies among developed nations. Women in Norway are highly educated and well represented in government. The country also boasts the highest female-to-male income ratio and is tied for the second-lowest under-5 mortality rate among developed countries.

At the bottom of the list is the African Nation of Niger. In Niger, only one in three births are attended by skilled health personnel. In addition, the country is currently in the midst of a “worsening hunger situation, threatening the lives of a million children”. Compared to Norway where women attend school for an average of 18 years, girls in Niger only attend only four years of formal schooling during their lifetime. Women in Niger have no economic or political power.
Rather than give a rundown of the best and worst countries (For a full list of each country and its ranking is available here.), I want to share the criteria Save the Children used in determining what made a country a great place for a mama and what made a country not so great for a mama. In all, Save the Children evaluated 165 countries and found that the following categories determined whether or not a country was a good or bad place for mothers and their babies.  (FYI, The United States Ranked #25)
  • Infant/Child Mortality. Many countries have staggering infant and child mortality rates. In Niger for example,virtually every mother will lose a child before the age of 5. This is primarily due to malnutrition and lack of health care resources. Unfortunately, children in the poorest countries will die from some of the most easily treatable diseases because they are malnourished and lack access to health care when they do in fact become ill.
  • Maternal Mortality. Many mothers worldwide are dying in childbirth or as a result of complications from childbirth. In the United States, One in 2,100 births result in the death of the mother which is a shocking statistic given the resources in this country. However, despite our vast resources, many women and children live in poverty in the United States and poverty is a strong indicator of mortality in both mothers and babies worldwide. In the US, the big gap in health care that’s available for well-off women vs. very poor women is the driving force behind the maternal (and infant) mortality numbers.
  • Economic Empowerment. It’s a known fact, when women can earn a living wage, they fare better and so do their children. In countries where women are able to earn a substantial income-nearly equal to that of a man, her health goes up and her mortality (risk of early death) goes down.
  • Education of Women and Girls. It stands to reason that if women aren’t educated, they cannot attain high paying jobs, cannot earn a living wage and cannot support themselves and their children. It’s a vicious cycle. In countries like Norway where women are highly educated, we see women economically secure and thriving. In countries like Mali, Afghanistan and Niger, where education of women and girls is scanty at best, we see a high rate of maternal and infant mortality and and those women and children that are “surviving” are living in abject poverty. Ms. Miles added,
    “The longer you keep girls in school, the longer they delay having their first child. And that child will be much healthier. A girl who has a baby at 14 is a much higher risk pregnancy, and her baby is at much higher risk of death, than a girl who gets pregnant at 17 or 18.  If she stays in school, it’s much more likely she’ll she’s going to wait until she’s older. That’s why education of girls is so important.”
  • Political Involvement. In countries where women are allowed to be involved in the setting of political and social policies, women are doing much better. No surprise. When you have no representation, you have no voice and no way of making your needs known.
  • Access to HealthCare. When women have readily accessible access to health care, their health and the health of their children is markedly improved. According to Ms. Miles, one of the reasons that Afghanistan was able to move from 165th to 164th is because of a surge in community health clinics.  “And a lot of these health centers are in the places where moms and babies do die, kind of at the end of the health system, if you will, at the end of the road, really remote areas where these moms are oftentimes giving birth at home. So, having a health clinic close at hand really saves lives.”
  • Maternity Leave. We also know that when women are allowed time off to give birth, recuperate from that birth and spend time with their babies bonding and breast feeding, both mothers and babies do well. One of the reasons that the United States ranked 25th in the Save the Children report is because of it’s poor maternity leave policy.”The report also notes that the U.S. has one of the least generous maternity leave policies of any wealthy nation. It is the only developed country — and one of only a handful of countries worldwide — that does not guarantee paid leave for working moms. Instead, by law, new mothers get 12 weeks of unpaid leave.”

We now know what it takes to make mamas and babies healthy. Now its time to implement these practices globally. It’s being done very successfully in many countries and very poorly in many more. Let’s hope that this new knowledge will bring forth improved standards of living and care for women and babies.

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