Best and worst mothers worldwide

By Dr. Ananya Mandal, MDMay 10 2012

Right in time for Mother’s day comes a report on the best and worst mothers worldwide. U.S. moms have moved up six places - from 31st to 25th - in the 13^th annual Save The Children State of the World's Mothers report. That puts the U.S. right between Belarus and the Czech Republic. Norway is No. 1, just ahead of Iceland and Sweden.

The report's ranking of 165 nations factors in measures of education, health and economic status as well as the health and nutrition of children. “There's still an awful lot that we need to do,” said Carolyn Miles, the president of Save The Children.

American moms have improved on fronts like better care for teen moms and also in electing more women to government positions, which the organization sees as an important measure of how society values women. But it has to do more, Miles and others stress. “We valorise parenthood and in particular, motherhood, while at the same time we offer very few supports,” said Robin Simon, a professor of sociology at Wake Forest University.

Following Norway, Iceland and Sweden are New Zealand, Denmark, Finland, Australia, Belgium, Ireland, Netherlands, U.K, Germany, Slovenia, France, Portugal, Spain, Estonia, Switzerland, Canada, Greece, Italy, Hungary, Lithuania, Belarus and the U.S.

The U.S. recognizes mothers for their incredibly important role as the primary caregivers to children but it still hasn't done enough to help raise the kids. Raising a child is stressful and really expensive. A new mother needs a lot of help, Simon said, and other countries provide more government assistance than the United States does. “Unlike other industrialized nations, we lack the kind of state-level protections and policies that would reduce some of that stress,” she said, speaking of “family-friendly entitlement programs” like universal health care.

Thanks to the 2-decade-old Family and Medical Leave Act, new mothers get 12 weeks of unpaid leave. In Canada, it's 52 weeks, 50 of which are paid. Kirsten Swinth, a professor of history at Fordham University who is working on a book on the cultural history of the working American mother, said companies that do offer paid leave do so more for professional middle - and upper - ranked workers. “That tends to leave lower-paid and less-skilled workers behind so there's an inequality in the distribution of those benefits,” she said.

The poor around the world are victims of growing inequality, the Save The Children report shows. The gap between the level of care and commitment to mothers and children in the top 10 nations - all developed countries - and the bottom 10 is growing, Miles said.

For example in Niger almost every mother will lose at least one child in her lifetime. It is the opposite in Norway, where every birth is attended to by a health professional. Miles said her organization has been working hard for the past five years to make sure there are more health workers to attend to births in those countries. “Forty percent of children that die under the age of 5 die in the first month,” she said. “And the most dangerous day for a child is the day they are born.”

Among the worst countries for motherhood are Democratic Republic of Congo at 156^th position followed by, South Sudan, Sudan, Chad, Eritrea, Mali, Guinea-Bissau, Yemen, Afghanistan and Niger.

Afghanistan switched places with Niger in western Africa. “More mothers are surviving and fewer children are dying and this is something we need to be celebrating,” said Rachel Maranto, Advocacy and Mobilisation senior Manager at Save the Children in Kabul. Afghan women have won back hard-fought rights in education, voting and work since the five-year austere rule of the Taliban was toppled by U.S.-backed Afghan forces in 2001. But their plight remains severe and Maranto warned that such gains are “fragile”.

The report emphasizes nutrition as a key factor in determining mothers' and their children's well-being. Malnutrition is the underlying cause of more than 2.6 million child deaths each year, it says. An additional 171 million children suffer stunted growth. Miles said, “We talk about the 'lifesaving six' things in nutrition, and one of those is breast-feeding practices,” she said. And everyone needs to pitch in, she said. Certainly moms need to take the lead, but governments also need to establish friendly policies toward breast-feeding and companies need to welcome it. It's one of the most important things that can save kids' lives, along with providing clean water, Miles said. “It has to be everyone saying, 'This doesn't have to happen in our country.'”

The findings should serve “as a fire alarm to countries and people to look at this situation and draw them together to come up with an action plan,” said Jennifer Requejo, a maternal and infant health researcher at Johns Hopkins University in Baltimore. She was not involved in the research.