Despite global maternal health agreements, which promise huge returns; and a renewed focus of late on the critical importance (did I really need to write that?) of investing in improving maternal health outcomes in this country, the United States still ranks 28th of 160 countries when it comes to the best and worst places to be a new mother around the world, according to a report released by Save the Children this month.

According to the New York Times, in an article published on May 17th:

The United States did not fare well; it was 28th, below Greece, Portugal and virtually all of Western Europe. It ranked just above Poland and most of the former Soviet bloc.

I imagine, already, those commenters and committed conservative voices clinging to the idea that somehow a ranking of 28th in the world is not that bad, that it’s women’s fault, that it’s the fault of a bloated court system allowing for too many malpractice suits which scare doctors and hospitals or my favorite – it’s because of access to legal abortion. But the reality is that the U.S. health care system, a system in which more money is spent per capita then any other in the industrialized world, is failing our mothers and newborns. How does this happen? Notes the NYT article:

The chief reason for the low American ranking, the authors said, was that despite advanced medical technology, more young mothers die, either in childbirth or in the years after, than in most rich countries. The United States also lost points because American working mothers get less maternity leave and lower benefits.

The thing is, while preventing as many deaths of mothers during or after childbirth and creating an optimal environment for new mothers to parent are crucial and worthy goals in and of themselves, the state of mothers’ lives has an immense effect on the health and lives of newborns, babies and families in the U.S. as well.

From a post I wrote a couple of months ago on the connection between breastfeeding rates in the United States and ensuring important rights for women like paid family leave, access to high quality health care and more,

Even though we spend more, per capita, every year on health care, we rank 37th in infant mortality in the world. According to Momsrising.org, when paid family leave is instituted we see a 25 percent drop in infant mortality rates. One of the reasons? It allows mothers the time to establish a breastfeeding relationship with their new baby.

As Kristin Rowe-Finkbeiner, founder and executive director of Momsrising.org told me this year,

The U.S. “stands out like a sore thumb with our lack of paid family leave”, says Rowe Finkbeiner. “Of over 170 countries, only four don’t have some form of paid family leave for new mothers: Papua New Guinea, Swaziland, Liberia and the U.S.”

And while it’s true that paid family leave is important, even more basic in poorer countries, notes the New York Times article, is the availability of a skilled female birth attendant – in particular a midwife, in countries like Afghanistan which was rated the worst place in the world to be a mother:

The most important factor in how mothers and babies fared in very poor countries was whether or not a female health worker helped at the birth. Since many men refuse to let their wives be seen by male doctors and many grandmothers give dangerous traditional advice, trained midwives can save lives, the authors said. After Afghanistan, the worst countries were Niger, Chad, Guinea-Bissau, Yemen, the Democratic Republic of Congo, Mali and Sudan; many are conservative Muslim countries where education for girls is discouraged.

How exactly do “pro-life” advocates square their stance that by blocking access to safe and legal abortion services in this country, while standing around and doing nothing to address war-torn (by the United States) Afghanistan’s dismal maternal mortality rates or addressing the circumstances in the U.S. which lead to the loss of womens’ and newborns’ lives at unforgivable rates, they are actually improving people’s lives? It’s hard to know, exactly. It’s hard to know because searching for maternal health advocacy efforts from any larger anti-choice organization yields pretty much nothing except the same virulent anti-abortion messaging for which they are known. Go ahead, try googling “pro-life maternal health” and see what you come up with. If you come up with anything at all unrelated to abortion, please let me know. 

Yet, here we stand in 2010, a report from the organization Save the Children in hand, letting us know that if you want to be treated with the respect, dignity and care you deserve, as a new mother, your best bet is to reside in Norway; and that your life is in danger should you reside in so many countries around the world from Niger to Afghanistan to Sierra Leone.

Is it an accident that the country rated safest for new mothers – Norway – is a country whose abortion laws are relatively liberal – with abortion allowed in the first and second trimesters and in the third, only under special circumstances? Of course not. Is it a coincidence that, according to the report, in the countries with the highest maternal mortality rates like Afghanistan, Angola, Chad and Niger, women’s status is abysmal, with women receiving less than four or five years of educaton in total?

Maternal health around the world is dependent upon the tenet that women must have the right to decide, for themselves or in concert with a health professional, what is best for their health and lives. Without access to health care from the most basic care to contraception, prenatal care, legal abortion, skilled birth attendants, postpartum resources, paid family leave, adequate education and more we allow for the conditions that keep women oppressed and we put women’s health and lives at risk, plain and simple.

Is it surprising that those countries in which women’s health and lives are routinely compromised are some of the poorest in the world? The temptation might be to say that these are the countries that cannot afford to invest in such complete overhauls of the system. But, of course, we know that when we raise the status of women and girls in a country, we improve the lives of children, families and in fact improve the economic status of a region as well. Are we so terrified of the true power of women and girls around the world, then, that we are willing to sarifice their lives? The number of reports are stacking up – we know where women’s health and lives stand around the world. Now, what are we going to do about it?