With Mother’s Day just around the corner, the Save the Children foundation released its 14th annual State of the World’s Mothers Report. This year, the U.S. ranks as the 30th best country to be a mom, dropping five spots from last year’s 25th-place ranking.
The annual report rates the well-being of mothers and children in 165 countries based on factors that range from a mother’s education to breast-feeding prevalence. This year, Finland ranks first, followed by Sweden and Norway, for having high scores in mothers’ and children’s overall health, educational, economic and political status.
This year’s report focuses on newborn health. Over 1 million babies die on their first day of life, and researchers from Save the Children and the London School of Hygiene & Tropical Medicine say the findings indicate that figuring out how to help newborns survive day one can help lower the child mortality risk.
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Since 1990, overall child mortality has decreased from 12 million annual deaths to less than 7 million. However, newborn mortality rates have proved more stubborn: 43% of child deaths occur during a baby’s first month of life, and more than a third happen on day one. “That’s a big percentage, which is why we are focusing on it. If we really want to drive down child mortality overall, we have to move that newborn number faster,” says Carolyn Miles, president and CEO of Save the Children.
The leading causes of newborn death are prematurity, birth complications and severe infections. More than 98% of first-day deaths occur in the developing world where infections and problems at birth are more common.
However, the U.S. is not exactly a role model for newborn survival, especially for a wealthy country. Among the industrial world, the report says the U.S. accounts for 60% of all first-day deaths; in 2011, about 11,300 babies died in the U.S. on their first day of life. Babies born to low-income moms are most at risk.
“That’s a shocking statistic in the U.S. A lot of the issue is around moms seeking prenatal care and knowing what they need to do to reduce those risks,” says Miles. “If you have ever been to the premie unit in a hospital in the U.S, we have amazing technology. It has more to do with moms seeking that prenatal care and getting the care they need.”
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Miles says the interventions that are going to be most effective are not high-tech and do not require cutting-edge hospitals or doctors to administer them. “Some of the success stories are in some of the poorest countries,” says Miles. “Look at places like Nepal, where they are really driving down those newborn deaths. That is a country with pretty simple interventions.”
In Nepal, infections are one of the major issues at childbirth. The use of a tube of antibiotics called chlorhexidine, which is widely available and inexpensive, is driving down the country’s newborn mortality rates. “Taking a clean razor blade and putting that antiseptic onto the umbilical cord of the baby has a big impact,” says Miles. “In Nepal, 63% of women give birth at home, so you need to get this antibiotic in the hands of health workers who are helping these mothers give birth in these rural areas and at home. Their government has made this a commitment.”
Overall, the report cites four interventions that could really make a difference in newborn death rates. Besides using chlorhexidine to cleanse umbilical cords, the researchers recommend steroid injections for women undergoing preterm labor in order to lower deaths in premature babies from breathing problems, resuscitation devices to save babies who are born not breathing and injectable antibiotics to treat newborn sepsis and pneumonia.
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“[To make these changes] it takes political will and it takes focus and continued support from donor governments like the U.S. and the U.K. and Germany,” says Miles. “It also takes countries where kids are dying to say, This doesn’t have to happen here.”