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Baby On Board? Consider Moving to Norway

The nonprofit Save the Children has released its 12th annual "Mothers Index," which says Norway is the best place to be a mother while Afghanistan is the worst. The U.S. ranks 31st. Host Michel Martin discusses the report's findings with Mary Beth Powers, the head of Save the Children's newborn and child survival campaign.

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Transcript

MICHEL MARTIN (Host): And now, as we get ready to honor mothers on Sunday, we wanted to take a look at how mothers are faring worldwide. This week, Save the Children released its annual report on the state of the world's mothers. It examines 164 countries, and ranks the world's best and worst places for moms. Norway was ranked number one this year, while Afghanistan was at the very bottom of the list. The United States, meanwhile, falls at number 31.

We wanted to talk more about this so we've called Mary Beth Powers. She is the leader of the Save the Children's Newborn and Child Survival campaign, and she's with us from our bureau in New York. Welcome. Thanks so much for joining us.

MARY BETH POWERS: Thanks, Michel. Glad to be here.

MARTIN: Why was Norway ranked number one this year? And I should mention that Norway was followed closely by Australia, Iceland, Sweden and Denmark.

POWERS: I mean, in many of those countries, you see the kinds of investment in women's health and children's health that makes a huge difference in the outcomes for moms and kids. And that's the reason that they consistently are at the top of the list. But there's a few other things. Like, they tend to have a lot of women in their national legislatures. And we consider that when moms are in Congress or moms are in parliament, they tend to make policies that are good for moms and kids.

MARTIN: I want to talk a little bit more about that in a minute, but I just want to get the flipside of the report, the less-happy news. Afghanistan was found to be the worst country for mothers. And they were followed closely by Niger, Guinea-Bissau and Yemen. What made them the worst places in the world to be mothers?

POWERS: I mean, in most of those countries, health care is not accessible to every woman. So the vast majority of women in Afghanistan, for example, deliver at home, often alone or with a neighbor. So maternal mortality rates are extremely high. Every pregnancy is risky. Many women don't use contraception. So you have this very, very high risk of death just trying to become a mother. And then the children of Afghanistan, and in a lot of sub-Saharan Africa, face inordinately high risk of death. And frankly, most of those deaths are preventable.

MARTIN: Well, I wanted to ask, though, about some of the factors that go into the rankings. I think some of the metrics that you use are things that I think everybody would agree with. Like, the lifetime risk of maternal death, the mortality rate for children under 5, having a skilled attendant at delivery - things of that sort, I assume everybody would agree with that. But there are other factors that go into the rankings - like the participation of women in national government, like you talked about earlier, or maybe maternity leave. That's a political issue in this country; it's an ongoing political issue in this country. So I wanted to ask, you know, why a factor like that, you think, needs to be in this report?

POWERS: You know, we talked to a lot of experts, and we talked to mothers themselves, about what other kind of factors that make you feel like this is a country that's invested in you being a good mom? And in fact, you know, the amount of time a woman gets for maternity leave - which is one reason that the United States ranks so far behind every other industrialized country - does make a difference in women's well-being, but also in children's well-being. So there are other factors that we put into the report, that maybe aren't sort of the straight health and education factors, but we think make a difference in people's success at mothering.

MARTIN: Well, the United States, as we mentioned earlier, is ranked number 31 on this report. The U.S. has the least generous maternity leave policy among its peer industrial, you know, economies and so forth. Is that the main reason that the U.S. ranks as low as it does, or are there other factors?

POWERS: Well, actually, the United States has among the highest child mortality rates in the industrialized world, and the highest maternal mortality rates in the industrialized world. So it's much riskier. And that's determined by a number of factors, including the fact that there are populations in the United States that don't get adequate health care during pregnancy; maybe underlying conditions, like diabetes or hypertension, don't get treated early in pregnancy or aren't diagnosed early in pregnancy so women go on to have premature deliveries; those kids are at higher risk, etc. So there's a bunch of factors that end up putting the United States in - really, kind of close to last place on some very important health indicators for moms and kids.

MARTIN: Just by way of example, a woman in the U.S. is more than seven times as likely as a woman in Italy or Ireland to die from pregnancy-related causes, and the risk of maternal death is 15 fold that of a woman in Greece, according to the report. So what I'm hearing you say is it's not just a matter of sort of political representation issues. There are really, some significant health differences for women in this country. I think people might be surprised at that. Do you think so?

POWERS: Well, I think - interestingly, just this week, the United Nations released the new data on global growth rates, population growth rates around the world. And some of the growth is going to take place in the United States, for example. And one reason is we tend to have, still, bigger families in the United States than a lot of our European colleagues. So it doesn't surprise me that compared to Italy, for example - where fertility is very low, so if you're not pregnant as often, you're not exposed to the risk of death in pregnancy or childbirth.

MARTIN: We're talking with Mary Beth Powers. She's the leader of the Save the Children's Newborn and Child Survival campaign. We're talking about Save the Children's annual report on the state of the world's mothers. It examines 164 countries, and it ranks the world's best and worst places for moms. Do you know where the U.S. was last year whereas number 31 this year - do you happen to remember where the U.S. was last year?

POWERS: Yeah. I think we were 28 so - I think 28 or 29 - so we dropped a couple of pegs. And it really does, again, have to do with these factors that are not really changing. I mean - that the U.S. maternal mortality rate and child mortality are not getting better. And in fact, you know, kids in Norway, in Japan, etc., are losing just three kids per thousand in terms of child mortality rates whereas in the United States, it's eight per thousand.

MARTIN: The report does point out that there are places where conditions are improving, particularly in developing countries. Malawi, for example, has cut its child mortality rate in half since 1990, a fact that's highlighted the report. What has Malawi done to make this improvement?

POWERS: I think it's really important to recognize the fact that certain governments have made a real political commitment, and then followed through on that commitment, to bring health care closer to every family. So in Malawi, there are health surveillance agents, they're called, but they're basically outreach workers who work in clinics, but also work in communities - basically visiting households, making sure moms, pregnant women are doing well through the pregnancy, and then going back and checking on kids to make sure kids get treatment from pneumonia, diarrhea, malaria - the three biggest killers of kids in Malawi.

And those kinds of investments - increasing immunization coverage, for example - has really, dramatically reduced child deaths due to preventable causes. So Malawi has a lot to be proud of.

MARTIN: So what are you thinking about this Mother's Day? What are you going to be thinking about?

POWERS: Usually on Mother's Day, you know, I do sort of the typical - I do a little bit of gardening. I often get garden plants from my kids. So I do some of that.

MARTIN: Breakfast in bed for you?

POWERS: I hope so, but I hope we don't serve it with syrup this year.

(soundbite of laughter)

MARTIN: OK. Mary Beth Powers is the head of Save the Children's Newborn and Child Survival campaign. She joined us from our bureau in New York. And if you want to read the report in its entirety - and we hope you will - we'll link to it on our website. Just go to NPR.org. Go to the Programs tab, and then click on TELL ME MORE. Mary Beth Powers, thank you so much for joining us, and Happy Mother's Day to you.

POWERS: Thank you so much, and to your listeners as well. Transcript provided by NPR, Copyright NPR.

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