There are many reasons to have a baby in the United States. We have pregnancy tests to give us the happy news as soon as possible. Prenatal ultrasounds and blood screenings check on the health of our baby-to-be. And when we enter the delivery room on that long-awaited day, we know that we'll receive some of the best care in the world.
But American mothers might cringe to learn that women in other countries pity us for maddening workplace practices -- short, unpaid maternity leaves; long working hours; and lack of childcare or support for breastfeeding -- that sabotage our best efforts to pursue our careers and take care of our kids. "This is not a child-friendly country," says Ann Crittenden, a Washington, D.C., writer who criticized this country's treatment of mothers in a best-selling book, The Price of Motherhood: Why the Most Important Job in the World Is Still the Least Valued. "No other mothers in the world have to work the way we do."
In BabyTalk's report card on the state of American mothers and children, we've used data from a wide range of sources to grade the U.S. in comparison to other countries in crucial areas, ranging from prenatal care and infant mortality to maternity leave and breastfeeding rates. What can American mothers be grateful for? And how could life be better, not just for us but for our children? The answers may surprise you.
The Health Of Mothers: A
Yes, American women still shudder at the thought of labor pains. But thanks to our high-quality health care, few moms-to-be are haunted by that age-old fear of womankind: dying in childbirth. About 96 percent of pregnant women in the U.S. receive prenatal care -- crucial for giving moms and babies the best shot at good health, as well as for preventing pregnancy and delivery complications.
And when it's time for a baby's debut, 99 percent of women in the U.S. deliver under the watchful eye of a trained birth attendant (whether a doctor, nurse, or midwife). In this country, mothers die in 12 out of 100,000 live births, placing us in the very low risk category. That's according to Population Action International (PAI), a Washington, D.C.-based group that ranked 133 countries in terms of reproductive risks.
But we're far from perfect. While overall rates of prenatal care are high, they mask the disturbing fact that in the U.S., roughly 13 percent of pregnant women lack health insurance. Too often, they fail to see a doctor during that all-important first trimester. "Because they lack health insurance, women will delay beginning prenatal care," says Rick Bucciarelli, M.D., a Florida pediatrician who chairs the American Academy of Pediatrics's (AAP) Subcommittee on Health Insurance Coverage and Access to Care.
Although most uninsured women eventually get into the doctor's office later in pregnancy, their poor access to care puts them at a 31 percent higher risk of suffering a health problem after giving birth, according to the American College of Obstetricians and Gynecologists. If the U.S. offered universal health coverage to all expectant mothers, we could make pregnancy even safer.
In Europe, where universal health insurance coverage is common, several countries surpass our high quality of health. Among Italy's achievements: 100 percent of women receive prenatal care, and 100 percent deliver with the help of a trained birth attendant. In three countries -- Norway, Canada, and Switzerland -- women die in childbirth at the rate of 6 per 100,000 live births, the lowest in the world.
But the care women get in America is a far cry from the abysmal conditions in developing nations where a woman may never see a doctor or nurse during pregnancy. Collectively, women in wealthier countries face only a 1 in 2,125 lifetime risk of dying in pregnancy or childbirth. In contrast, women in poor nations run a 1 in 65 lifetime chance -- a risk that is 33 times greater. American women are also less likely to be affected by one of the world's great killers: While only 0.2 percent of U.S. women have HIV or AIDS, an astounding 27.5 percent of women in Zimbabwe are infected, according to PAI.
