A 15-year-old mother holds her 9-day-old baby in Bangladesh, where 153,000 newborns die each year.
Research: 2 million babies die in first 24 hours each year worldwide
An estimated 2 million babies die within their first 24 hours each
year worldwide and the United States has the second worst newborn mortality
rate in the developed world, according to a new report.
American babies are three times more likely to die in their first month
as children born in Japan, and newborn mortality is 2.5 times higher in the
United States than in Finland, Iceland or Norway, Save the Children researchers
Only Latvia, with six deaths per 1,000 live births, has a higher death rate
for newborns than the United States, which is tied near the bottom of industrialized
nations with Hungary, Malta, Poland and Slovakia with five deaths per 1,000
"The United States has more neonatologists and neonatal intensive care
beds per person than Australia, Canada and the United Kingdom, but its newborn
rate is higher than any of those countries," said the annual State of the
World's Mothers report.
The report, which analyzed data from governments, research institutions and
international agencies, found higher newborn death rates among U.S. minorities
and disadvantaged groups. For African-Americans, the mortality rate is nearly
double that of the United States as a whole, with 9.3 deaths per 1,000 births.
Sub-Saharan Africa remains the worst place in the world to be a mother or child,
with Scandinavian nations again taking the top spots in the rankings by the
Connecticut-based humanitarian group.
Sweden heads the list, with Niger last. (10
worst and best)
The "Mothers' Index" in the report ranks 125 nations according to
10 gauges of well-being -- six for mothers and four for children -- including
objective measures such as lifetime mortality risk for mothers and infant mortality
rate and subjective measures such as the political status of women.
Charles MacCormack, president and CEO of Save the Children, said the report
card "illustrates the direct line between the status of mothers and the
status of their children."
"In countries where mothers do well, children do well," he said in
a written statement accompanying the report.
But each year, according to the report, more than a half-million women die
as a result of pregnancy and childbirth difficulties, 2 million babies die within
their first 24 hours, 2 million more die within their first month and 3 million
An unhealthy start
As Americans celebrate Mother's Day on Sunday, "5,000 mothers will mourn
the loss of the newborn they bear that very day in the developing world,"
said Anne Tinker, director of Save the Children's Saving Newborn Lives initiative.
"All children, no matter where they are born, deserve a healthy start
in life," Melinda Gates wrote in a foreword to the report, which was funded
in part by the foundation she runs with her husband, Microsoft co-founder Bill
MacCormack said "significant progress" had been made in reducing
deaths in children under age 5 in recent years, but "we have made little
progress in reducing mortality rates for babies during the first month of life."
Causes of death in the developing world were dramatically different from those
in the developed world, the report said. In industrialized nations deaths were
most likely to result from babies being born too small or too early, while in
the developing world about half of newborn deaths were from infection, tetanus
The newborn mortality rate in the United States has fallen in recent decades,
the report said, but continues to affect minorities disproportionately.
Only 17 percent of all U.S. births were to African-American families, but 33
percent of all low-birthweight babies were African-American, according to the
The research also found that poorer mothers with less education were at a significantly
higher risk of early delivery. The study added that in general lower educational
attainment was associated with higher newborn mortality.
Tinker said Japan was among a number of nations highly ranked mainly because
they offer free health services for pregnant women and babies, while the United
States suffers from disparities in access to health care.
"We can do better here, but what's really important is that we do something"
in the developing world, she said.
The report said almost all newborn and maternal deaths take place in developing
nations -- 99 percent and 98 percent, respectively. The newborn mortality rates
were particularly high in countries with a recent history of armed conflict,
including Liberia and Sierra Leone.
But the report also concluded that political will was more important than national
wealth. A "newborn scorecard" ranking 78 developing nations found
that some relatively impoverished countries -- including Colombia, Mexico, Nicaragua
and Vietnam -- fare better than others.
Ranking at the bottom of the scorecard were Liberia, Afghanistan, Angola and
Iraq -- countries where armed conflict and cultural practices impede newborn
"It's tragic that millions of newborns die every year, especially when
these deaths are so easily preventable," Gates wrote. "Three out of
four newborn deaths could be avoided with simple, low-cost tools that already
exist, such as antibiotics for pneumonia, sterile blades to cut umbilical cords
and knit caps to keep babies warm."
'The good news'
The Mothers' Index -- which excluded some nations that lacked sufficient data
-- highlights huge disparities between the nations at the top and the bottom
of the list.
Compared with mothers in the top 10 countries, a mother in the bottom 10 was
found to be more than 750 times more likely to die in pregnancy or childbirth.
In top-ranked Sweden, skilled personnel are present at nearly all births, but
in bottom-ranked Niger, such help is available for only 16 percent of women
"The good news," said MacCormack, "is that we know what it takes
to help these moms and children survive and thrive."
The report highlights the three areas it says have the most influence on child
well-being: female education, presence of a trained attendant at birth and use
of family planning services.
Educated women, the report said, are more likely to marry and give birth later
in life, to seek health care and to encourage education for their children,
The report said that family planning and increased contraception use leads
to lower maternal and infant death rates. Many women and children in developing
nations, it said, die as a result of births that come at the wrong time -- too
close together, too early or too late in the mother's life.