It is life's most basic relationship: a mother and her newborn. Yet, as we celebrate Mother's Day in the United States, how many of us fully understand the needless tragedy that so many mothers face every day around the world the loss of their babies due to preventable causes or the lack of basic health care?
As you read this, five thousand mothers who give birth today in poor countries will see their babies die within the next twenty-four hours. Maternity wards in the United States are usually scenes of joy. But in too many poor countries around the world, what should be the happiest moment of a woman's life giving birth to a baby has become a dance with death.
The latest numbers, as reported in Save the Children's annual State of the World's Mother's report, are staggering. Each year an estimated two million newborns die within their first twenty-four hours of life, while an additional two million babies die before they are a month old.
To put those numbers in perspective, four million babies are born every year in the United States, but only sixteen thousand do not survive their first month a newborn mortality rate ten times lower than in many developing countries. (The newborn mortality rate in the United States still lags other industrialized countries such as Norway and Japan, however.)
The primary causes of newborn deaths in the developing world are commonplace, and include pregnancy-related complications such as low birth weight, premature delivery; or asphyxia during labor, and infections like tetanus or pneumonia. Another big factor: sixty million women in the developing world give birth at home each year with no skilled attending care.
It doesn't have to be this way. As many as three million newborns and tens of thousands of their mothers could be saved each year through simple, low-cost interventions such as immunizing women against tetanus, providing a skilled attendant at birth, treating newborn infections promptly, encouraging breastfeeding immediately after birth, and making more information about family planning available.
Besides improving basic health services, simple changes in traditional cultural practices performed at childbirth also can make a big difference. In poor regions of Bolivia, for example, umbilical cords are often cut with a sharp stone or piece of ceremonial clay pot that is made during pregnancy and broken at the time of birth because people believe using a knife or blade will cause the baby to grow up to be a thief. Save the Children has worked to educate Bolivian families to sterlize the stones or piece of clay pot by boiling them. Both approaches respect tradition and prevent infection.
Overall, ten countries account for more than two-thirds of the four million newborn deaths worldwide every year. India leads the list with more than one million newborn deaths per year, and China is next with 416,000. But India and China have huge populations, and their rates of newborn deaths do not rank among the world's highest. That tragic claim belongs to sub-Saharan Africa, where in some countries one in every five mothers has lost at least one baby in childbirth.
So where is the good news about child survival in the developing world? Our recent report shows Vietnam and Nicaragua making significant progress in keeping newborn death rates relatively low, even though they are low-income countries. In Vietnam, girls are encouraged to stay in school and have babies later, when their bodies are more mature. More than half of Vietnamese women use modern contraception, which has been shown to save lives by helping mothers to space births at healthy intervals. In addition, nearly all pregnant women receive prenatal care, including tetanus vaccinations. Most have a skilled attendant at delivery who knows to keep the baby warm and to urge the mother to breastfeed exclusively starting within an hour after delivery. In Nicaragua, nearly all women are literate and two-thirds use modern contraception.
Save the Children is encouraging governments worldwide to invest more in education and health care for girls, women and newborns, as well as to provide the low-cost, low-tech solutions that save lives. We know from experience that these simple solutions work.
One encouraging sign: There is growing support in Congress for legislation that would authorize increased resources to reduce maternal, infant, and child mortality. The measure would also call on the U.S. government to implement a strategy to promote the health and well-being of mothers and children around the world. The House already is considering the legislation, and this week Senators Gordon Smith (R-OR) and Chris Dodd (D-CT) introduced similar legislation in the Senate.
For millions of mothers worldwide, helping ensure the survival of their babies would be the greatest Mother's Day gift of all.
Charles MacCormack is president and CEO of Save the Children, an independent global humanitarian organization, based in Westport, Connecticut. Anne Tinker is head of the agency's Saving Newborn Lives initiative, which is supported by the Bill & Melinda Gates Foundation.