Prenatal care, pregnancy knowledge, access to healthcare professionals, post-birth resources and maternity leave exist as several key aspects in determining a healthy birth, baby, and mother. The Mothers' Index, a report compiled by Save the Children, ranked 179 countries based upon these factors among others to determine the best and worst countries to give birth.
Worldwide, according to the World Health Organization (WHO), nearly 830 women die from preventable causes related to pregnancy and childbirth. Limited or no access to skilled care during pregnancy, at delivery, or after birth can dramatically increase the risk of death to a mother and child.
The worst ten countries to give birth in included Haiti and Sierra Leone (tied for 170), Guinea-Bissau, Chad, the Ivory Coast, Gambia, Niger, Mali, the Central African Republic, DR Congo, and Somalia, which earned the last spot.
The statistics are shockingly different regarding the 10 best and 10 worst countries; in the top 10 countries, statistics show that 1 in 12,160 women will die due to maternal causes while the number in the 10 worst countries is 1 in 30.
While Canada ranked 20 out of 179 countries and the UK ranked 24, the United States came in at 33, dropping two spots from its previous ranking. The Mothers' Index used data to conclude that women giving birth in the United States faced an approximate risk of maternal death of 1 in 1,800. Statistically, these are the worst birthing odds among all developed countries on a global scale.
Countries outranking the United States in terms of maternal care included Ireland, Korea, Poland, and Croatia. Slovakia, Serbia, and Argentina closely followed the U.S. with rankings of 34, 35, and 36.
The fact that one of the greatest and wealthiest countries in the world has the maternal death odds that it does in this day and age is sad and frightening. While more of a push to bring back doula and midwife care may help, we still face tremendous disadvantage when it comes to ensuring the health of baby and mama.
And if you are a woman of color in the United States? Your odds are even worse, leading us to shake our heads and wonder how this can be almost 20 years into the 21st century.
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What is it that these top countries do? What can we learn from their success rates with birthing?
The WHO says that skilled care before, during and after childbirth can save the lives of women and newborn babies. And, much of those success rates and saved lives come from the societal public view of a woman's pregnancy period and her postpartum period.
For example, in Norway, all maternity care is public and there is a HUGE emphasis on preventative care. Compare that to India, where preventative care is little option but to the wealthy, or even to many in the United States whose insurance dictates the skimpy support visits for pregnant women.
As well, in Norway, there is an incredible maternity benefit mothers can count on long before they're even pregnant, and this can make their pregnancy period one of less stress and anxiety as well. Mothers OR fathers are able to choose to take 12 months of maternity leave (yes, that's a year!) and still receive 80% of their pay from their jobs OR they can take 10 months of maternity leave and still receive their FULL PAY. Yes, the leave can be shared between mothers and fathers!)
Imagine what it could look like in America if we decided our politicians didn't need to have quite the same pension benefits they do now since they're representatives working part-time, and instead those pension dollars went into the future of our mothers and children in health care?
Mothers in Norway are mandated to take two weeks off before the births of their babies, and fathers are mandated to take the first two weeks after the baby is born, but otherwise, the maternity benefit can be shared as the couple chooses to do so. Again, what a great way to support mama, and even the concept of lying-in, as is another feature of countries that have better birthing rates.
In Finland, new mothers are given baby boxes when they give birth. A practice that started in the 1930s, the boxes are filled with the basic necessities a new mama needs for her new babe. The box also doubles as a makeshift crib or Moses basket, and Finland encourages their new parents to spend that precious, important time bonding with their babies too. Mothers are guaranteed about four months of paid maternity leave and then parents are able to split another additional six months of leave-paid-sharing the time that they are home for their new one.
In all of the top countries, midwives and doulas are more staple than they are in the states, where you're looked at as an 'alternative birther' if you choose to go with a doula or midwife, or give birth at home rather than with a medical doctor in a hospital setting. Perhaps if we gave more support to these options, more women would feel more comfortable and supported in their prenatal (and postnatal) care, and this could contribute to a better maternal and fetal health outcome.
The problem is not going to get better until we recognize it's a problem though. We continue to advocate for moms to feel supported in their pre- and post-natal periods, and we hope that raising awareness about how we could look at fellow first-world nations opens even more eyes with possibility.