24. U.S. Trails Most Developed Nations in Maternal Health Ranking

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, D.C.

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, she said.

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."