U.S. Ranks 25th In Best Places For Moms & Kids

by Jenny Hontz
July 10, 2012

USA! We’re number … 25? The United States moved up six spots from last year in Save the Children’s annual index of the best and worst places in the world for mothers and children, but it hardly seems like a ranking to cheer about.

Norway, Iceland, and Sweden topped the list of 165 nations, while Niger ranked last. Eight of the bottom 10 countries are in sub-Saharan Africa. Factoring into the rankings were maternal and child mortality rates, nutrition, contraception use, maternity leave policies, education, female-to-male income ratios, and women’s political representation.

So why does a nation as wealthy as the U.S. rank below countries such as Belarus, Estonia, and Lithuania? Maternal and child mortality rates are too high, maternity leave policies too stingy, and not enough women breastfeed. Here’s how it all breaks down:

Maternal mortality: Mothers in the U.S. face a 1-in-2,100 risk of maternal death—the highest in the industrialized world, the report said. Women in the U.S. are 15 times more likely to die from pregnancy-related causes than women in Greece, for instance. Lack of access to care, as well as high rates of obesity and C-sections, are contributing factors.

Minorities and women living in poverty are especially at risk. African American women in the U.S. are four times as likely as white women to die from pregnancy-related complications, according to a 2010 report from Amnesty International.

However, now that the U.S. Supreme Court has upheld the Affordable Care Act, access to prenatal care could improve in coming years.

Child mortality: The U.S. also performed worse than 40 other nations with regard to mortality rates of children under the age of 5. The under-5 mortality rate tends to increase when mothers give birth under difficult circumstances, when infants are not exclusively breastfed, and when children are not immunized, according to the State of the World’s Mothers report.

Breastfeeding rates: While 75 percent of American babies are initially breastfed, only 35 percent are breastfed exclusively at three months, the report says. The World Health Organization urges women to breastfeed exclusively for six months and to continue breastfeeding (in addition to complementary foods) for at least two years. The low breastfeeding rates in the U.S. add an estimated $13 billion to medical costs and account for an additional 911 infant deaths each year.

Breastfeeding practices vary widely in the U.S. across racial, ethnic, education, and income levels. More than 80 percent of Hispanic and Asian mothers initiate breastfeeding in the U.S., while only 74 percent of white women and 54 percent of black women do so. Mothers with higher levels of education are more likely to breastfeed, but even among college graduates, black women are less likely to breastfeed than white women. A recent study in the U.S. found that less than 2 percent of low-income mothers who planned to breastfeed were able to meet their goals. “Perhaps the most effective way to improve breastfeeding rates is to provide longer periods of paid maternity leave,” the report said.

Maternity leave: Sadly, the U.S. has the least generous maternity leave policy (you can read more about this here) of any wealthy nation and is one of only a handful of countries in the world that does not guarantee working mothers any paid leave after giving birth. Lack of maternity leave explains why the U.S. ranked last among 36 developed nations on Save the Children’s Breastfeeding Policy Scorecard. (Click here to read baby gooroo’s article, “Making Breastfeeding Work While Working.”)

In addition, the U.S. placed in the bottom 10 of developing countries in terms of preschool enrollment and the national political status of women. U.S. women hold only 17 percent of national government seats, compared to 40 percent in Norway and Iceland, and 45 percent in Sweden. And if there’s one takeaway message from the report—women’s political participation counts. Countries with more women in national government also have more generous maternity leave policies, better access to health care, and higher rates of breastfeeding. Perhaps the best thing you can do for families in the U.S. is elect more women—or run for office yourself.