Pregnancy, Childbirth Leading Cause of Teen Death for Girls in Poor Countries

Jim Lobe, OneWorld US

WASHINGTON, D.C.,  (OneWorld) - Pregnancy and childbirth are the leading cause of death for adolescent mothers in the world's poor countries, according to the fifth annual 'State of the World's Mothers' report issued here Tuesday by Save the Children.

More than one million infants - and an estimated 70,000 adolescent mothers - are dying each year in developing countries because young girls are marrying and having children before they are ready for parenthood, according to the 38-page report, 'Children Having Children'.

The most effective way to overcome the problem is to increase resources for education for girls in poor countries, particularly in sub-Saharan Africa where teenage pregnancy is most common.

The report, which includes an 'Early Motherhood Risk Ranking' that identifies 50 countries where motherhood is particularly dangerous to young girls and their babies, says that nine of the 10-highest risk countries are found in Africa, with the West African nations of Niger, Liberia and Mali topping the list.

"Access to education is key," said Charles MacCormick, Save the Children's president. "Research shows that girls who receive an education are less likely to have babies at a young age. Even mothers with only a basic education have healthier pregnancies, safer deliveries and healthier babies because they are more likely to seek health care services for themselves and their children."

The report, which also includes annual Save the Children's annual ranking of 119 countries of the State of the World's Mothers, based on their health, education, and political status.

As in the past five years, the Scandinavian nations of Sweden, Denmark, and Finland dominated the top ranks, while the lowest-ranked countries are all found along a band of nations that run from Guinea-Bissau and Mauritania in the west to Yemen in the east, with Niger, Burkina Faso, Ethiopia, and Mali filling out the bottom of the list. The United States ranked number 10, behind Nordic, West European nations, Australia, and Canada.

The criteria used to rank the countries include six indicators of women's well-being - lifetime risk of maternal mortality; per capita contraception use; percent of births attended by trained personnel, incidence of anemia among pregnant women; adult female literacy rate; and participation in the national government - and four indicators of children's well-being - infant mortality rate; gross primary enrollment rate; access to safe water; and extent of malnutrition.

The U.S. ranking is due in part to its having a maternal mortality rate of one in 2,500 - roughly the same as Bulgaria and significantly worse than the Nordic countries, western Europe, and even much of Central Europe. Similarly, with an infant mortality rate of seven per 1,000 births, the U.S. tied with Cuba in the Index and fell below virtually all of Europe.

In addition, the U.S., where women hold only about 14 percent of seats in the Congress, ranked below about a third of the countries on the Index, including most of the Caribbean, much of Latin America and Asia, several African countries, and most other industrialized nations.

As in past years, the report underlines the huge gaps between world's wealthiest nations and the poorest.

Thus, a mother in the bottom ten countries is 26 times more likely to see her child die in the first year of life and 750 times more likely to die herself in pregnancy or childbirth than a mother in the top ten countries.

Similarly, in the bottom ten countries, one out of three children is not enrolled in school, and only one out of four adult women is literate. Primary school attendance and literacy are virtually universal in the world's wealthiest nations.

The report found that access to and use of modern contraception is closely correlated with a decline in the deaths of mothers and children. In the U.S., for example, where 71 percent of women use modern birth control, one in 2,500 mothers dies in childbirth and only seven out of 1,000 infants die in their first year of life.

In Mali, where only six percent of women use birth control, one in ten mothers dies in childbirth, and one in eight infants dies before reaching his first birthday. Fewer than five percent of women use modern contraception in Burundi, Central African Republic, Chad, Eritrea, Guinea-Bissau, Niger and Sierra Leone

While the situation in parts of Africa has remained disappointingly static over the five years during which Save the Children has published 'State of the Mothers', it noted that several Latin American countries - notably Chile, Cuba, and Costa Rica - are approaching the achievements in women's and children's welfare by the world's most developed countries.

The heart of this year's report, however, lies in the 'Early Motherhood Risk Rankings' which note that in the 10 highest risk countries, more than one in six teenage girls aged 15 to 19 give birth each year, and nearly one in seven of the babies born to these girls die before age one.

The rankings are based on marriage and birth rates among teenage girls as well as infant mortality rates for children born to teenaged mothers in each country.

Outside of the poorest nations in Africa, the Early Motherhood Risk Ranking identified Afghanistan, Bangladesh, Guatemala, Haiti, Nepal, Nicaragua, and Yemen as those posing the greatest dangers to young mothers and their infants

"Childbirth can be a dance with death for young girls and their babies," said MacCormack. "Girls are marrying and having children before they are emotionally and physically ready. Often they don't have a choice".

This year's report includes stories of the lives of early mothers that help demonstrate that in some parts of the world, childhood for girls is extremely short-lived. In one case cited in the report, a mother says she was married at seven, had sex at nine, and was widowed at 12.

An estimated 115 million school-aged children - about 60 percent of whom are girls - are not actually attending school, according to the report which cited a series of other major findings, including

- Each year, one in every ten births worldwide is to a mother who is herself still a child.

- Girls in their teens in poor countries are twice as likely to die from pregnancy- or child-birth-related causes compared with older women, while girls 14 and under face even higher risk.

- Children born to children are more likely to be delivered prematurely and die in their first month of life.

- Birth rates for adolescent girls in the U.S. are the highest among 30 industrialized world and are even higher in some remote rural communities than in many poor countries. Indeed, at 53 births per 1,000 women aged 15 to 19, the U.S. has almost twice as many teenage births as the next highest, Russia, and almost 20 times as many as South Korea, which, at 3 per 1,000 women, is the lowest-ranked in the industrial world.

To deal with these challenges, the report recommends that the U.S. Congress increase aid for basic education, child survival, maternal health and family planning programs in poor countries and for in-school and after-school literacy programs in the U.S. Globally, the report calls for minimum-age laws for marriage be improved and enforced.