24. U.S. Trails Most Developed Nations in Maternal
Sources: SAN FRANCISCO CHRONICLE Date: 7/25/95; "Deadly Differences
in Prenatal Care," Author: Ramon G. McLeod; THE NEW YORK TIMES
Date: 7/26/95, "In a Ranking of Maternal Health, U.S. Trails Most
Developed Nations," Author: Philip J. Hilts
SYNOPSIS: An estimated 1.3 million women die worldwide every
year from complications of pregnancy and childbirth, according to a
report from Population Action International, a think tank in Washington,
The problem results from a deadly confluence of economic and social
factors related to pregnancy and childbirth, most associated with a
lack of prenatal care and medical personnel, according to the researchers.
The study reviewed data in ten categories of maternal health and gave
each of the 118 countries surveyed a score based on its performance
in those categories. Areas rated included the number of women who die
during childbirth, teenage pregnancy, contraceptive use, prenatal care,
and availability of safe abortions.
The countries with the best overall rankings were, in order, Italy,
Denmark, Norway, Sweden, and Belgium. Ranked the worst were Mali, Congo,
Somalia, Angola, and Zaire. In the latter three countries, the average
woman has more than six babies in her lifetime, and maternal death rates
range from 600 to 1,000 per 100,000 births.
The study shows that the chance of dying from pregnancy or childbirth
varies dramatically in different parts of the world, from 1 in 7 in
Mali to about 1 in 17,000 in Italy.
The rate in the United States is 1 in 5,669 and the U.S. was ranked
18th. The U.S. did not rank higher among the developed nations largely
because of teenage pregnancies-its rate is about six times that of European
nations-and a relatively low rate of contraceptive use.
Although it still fell in the study's "very low risk" group
of countries, the United States ranked behind such emerging countries
as Taiwan and Singapore.
Dr. Shanti R. Conly, Director of Policy Research for Population Action
International, warned that the U.S. "is likely to drop even farther
if this Congress continues as it has started." A proposal to end
public contraceptive services in the U.S. has been approved in committee,
Although an important factor affecting the ranking is a country's relative
wealth, according to Dr. Conly, some quite poor countries have worked
on women's health issues and ranked well, while other nations of great
wealth scored relatively poorly.
SSU Censored Researcher: Doug Huston
COMMENTS: Ramon G. McLeod, author of the San Francisco Chronicle
article, said the subject of "prenatal care of women in the Third
World, and even in industrial states, is hardly one that gets much attention
in the media. It just isn't the kind of subject matter that grabs a
lot of journalists, male or female. The reason, I think, is that most
U.S. editors and writers don't see it as an issue that affects Americans
much. The reality is that it affects us both directly and indirectly.
"High maternal death rates are almost always found in countries
with unstable populations. When women are healthier they have healthier,
and fewer babies. So while the average American reader may not care
about whether a mother in Kenya survives childbirth, she may care a
great deal about the impact of high population growth on the environment
and immigration pressures. And if she cares about these issues she may
be more willing to support the funding increases needed to help other
women survive their childbirths."
McLeod feels the only ones who benefit from the lack of coverage are
those that "don't want to spend any money on overseas development
or who may somehow believe that improving maternal health equals abortion,
which it doesn't."