Where's the best/worst country to be a mom?

(CBSNews.com) - Just 15 years ago, the United States was among the top 10 countries in the world to be a mother, but the U.S. has fallen to 31st on the list of 178 nations, a new report released Monday says.

According to Save the Children's 15th annual State of the World's Mothers Report, the risk that a 15-year-old girl will die in the U.S. during her lifetime from a maternal cause has soared 50 percent since 2000. The group cites multiple health studies as contributing factors - including an increase in high-risk pregnancies among mothers with obesity and hypertension.

Finland once again topped the organization's Mothers' Index, which is derived from health, educational and economic factors. Somalia - beset by both conflictand natural disaster - ranked at the bottom of the list. Across the globe, 56 percent of all maternal and child deaths occur in countries ravaged by war or disasters, the report said.

(Scroll to the bottom of the page to read how Finland takes better care of mother compared to the United States)


1. Finland

2. Norway


4. Iceland

5. Netherlands

6. Denmark

7. Spain

8. Germany

9. Australia *

9. Belgium (tied)


169. Cote d'lvoire

170. Chad

171. Nigeria

172. Sierra Leone

173. Central African Republic

174. Guinea-Bissau

175. Mali* 175. Niger (tied)

177. Democratic Republic of Congo

178. Somalia

According to the report, in Somalia, more than 6 percent of women are likely to die of a maternal cause, while about 15 percent of children will die before their 5th birthday. By contrast, maternal deaths affect less than one in 12,000 women in Finland, and just one in 345 children will die before the age of 5.

Earlier this month, the United Nations said more than 200,000 Somali children under the age of 5 are "acutely malnourished."

"Nothing will stop a mother from trying to keep her children safe and protected," said Carolyn Miles, President and CEO of Save the Children, "But when disaster strikes, whether it's a war in Syria, a tornado in Oklahoma or a typhoon in the Philippines, women and children are at the greatest risk - 14 times more likely to die than men."

Mothers and children are particularly vulnerable in war-town countries. In Syria, for example, an estimated 1.4 million children and nearly 700,000 women have sought refuge in neighboring countries, while over 9 million people inside Syria need lifesaving humanitarian aid, the reports said. In December, the U.N. asked for $6.5 billion to deliver food, shelter and health care in Syria.

The report also cited "horrific abuses against women and children" amid civil war in the Democratic Republic of Congo. According to Save the Children, it is statistically more dangerous to be a woman or child than an armed fighter in the Democratic Republic of Congo, which ranked second to last in the rankings.

However, the report did cite some good news in Afghanistan. The country, which ranked dead last in the rankings in 2010 and 2011, moved up 32 places this year. The report credited better midwife training, immunization programs and more educational opportunities for girls for the progress.

Save the Children called on better humanitarian access in war zones as well as improved preparedness in regions prone to natural disasters.

"Failure to address basic human needs has been both a cause and a consequence of conflict in countries like Central African Republic, Somalia and Sudan," the report concluded. "And the hardest hit families in any disaster - be it 'natural' or man-made - tend to be the poorest of the poor, mostly women and children."

With Mother's Day looming, Miles urged more focus on mothers who live in countries plagued by humanitarian crises.

"While we celebrate the mothers in our lives this week," she said, "we should also advocate for those who are in urgent need."

10 News asked Savethechildren.org additional questions about the rankings:

- What is Finland doing to support mothers better than the United States?

Finland has ranked in the top 10 on the SOWM index for the last 15 years, and has consistently demonstrated strong national support for children and families. A few points that differ from the US:

1. Maternal death is a rare event in Finland

2. Nearly every Finnish child - girl and boy alike - enjoys good health services and education. The typical Finnish child stays in school for 17 years.

3. Finland has 380 times the national wealth of Somalia, which ranks last on our index this year.

4. Finnish women hold three times as many parliamentary seats: 43 percent in Finland compared to 19 percent in the US.

5. Public daycare is guaranteed for all children under 7

6. Lengthy maternity, paternity, and parental leave are offered to all families, with additional financial support for single parents

7. Flexible and shorter work schedules are available for parents until the child's second year in school

8. Free health care from municipal health centers are available for all children

- What could the United States do better to earn a TOP SPOT on the list?

The U.S. needs to a better job at investing in mothers before, during, and after pregnancy to reduce its relatively high maternal mortality rates for a developed country. This will also help improve child mortality rates, which are not improving as fast as they could be.

The US could invest in affordable, quality health care for ALL women and children in the US. The report shows that we have significant disparities geographically and demographically, with poor women and minorities - namely women of color - being hit hardest by this crisis. In New York City, black women have a maternal mortality rate of 79 deaths per 100,000 live births, compared with 10 per 100,000 live births for white women. This means that black women in NYC have worse maternal mortality rates than women in either Syria or Iraq.

- Explain how you rank the countries and why is it important for you to do this?

The rankings reflect a composite score derived from five different indicators related to maternal well-being (i.e. maternal health, children's well-being, educational status, economic status and political status).

Lifetime risk of maternal death: No mother should die giving life. A woman's risk of maternal death is a product of the number of pregnancies/births she has, the spacing of births and the conditions under which she gives birth (amongst other things). Maternal mortality is also a good measure of the strength of national health systems.

Under-5 mortality rate: A mother's well-being is intimately connected to the health and well-being of her children. The rate at which children die before they reach five years of age is a leading indicator of child well-being, reflecting the health and nutrition of children, as well as their mothers. It is also a way of measuring how effective healthcare interventions for children are, as well as the quality of care mothers receive before, during and after pregnancy.

Educational achievement: Education is a basic human right and a powerful determinant of life quality. Numerous studies show a robust relationship between years of schooling and a number of important life outcomes, including income, health and civic participation. And when a girl is educated, her children are more likely to survive and be healthy and well-schooled.

Economic status: Not only is economic empowerment of women important for their own well-being. Mothers are likely to use the resources they control to promote the needs of their children. Gross National Income per capita is the best measure available to gauge a mother's access to economic resources and, therefore, her ability to provide for herself as well as for her children.

Political status: When women have a voice in politics, issues that are important to mothers and their children are more likely to surface on the national agenda and emerge as national priorities.

- What do you hope US mothers will do with this information?

We hope that mothers will visit Savethechildren.org to learn more about how they can advocate for better health for themselves and their children, as well as for mothers and children around the world who are facing even worse circumstances. On the website U.S. mothers can find stories, videos that can also help tell this story of moms in the U.S. and around the world who need our help.


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