- The Washington Times - Wednesday, May 10, 2006

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 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, 5,000 mothers who give birth today in poor countries will see their babies die within the next 24 hours. Most maternity wards in the United States are scenes of joy. But in too many poor countries around the world, what should be the happiest day of a woman’s life — giving birth to a baby — has become a dance with death.

The latest numbers, as reported this week in Save the Children’s annual State of the World’s Mother’s report, are staggering. Each year an estimated 2 million newborns die within their first 24 hours of life and another 2 million die before they are a month old. That’s 4 million newborns who die each year in the first month of life, most from causes that can be treated or prevented. While mortality rates for children under 5 worldwide have declined significantly in recent decades, little progress has been made in reducing death rates for newborns.

To put this in perspective, 4 million babies are born every year in the United States, but only 16,000 do not survive their first month — a newborn mortality rate one-tenth that of many developing countries (However, the newborn mortality rate in the United States is still behind many other industrialized countries like Norway and Japan.)

The primary causes of newborn deaths, while rare in the U.S., are common in the developing world: pregnancy-related complications like low birthweight or premature delivery; injuries or asphyxia during labor; and infections like tetanus or pneumonia. Another big factor: 60 million women in the developing world give birth at home each year with no skilled care.

Babies born to poor mothers in rural areas face perhaps the greatest challenges to survival. An analysis of 50 developing countries found babies born to the poorest mothers were almost 30 percent likelier to die than babies born to the richest mothers. Newborns in rural areas were found 21 percent more likely to die than those in urban areas.

It doesn’t have to be this way. As many as 3 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 immediate breastfeeding after birth and making more information available about family planning.

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 clay pot 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 Bolivians families to sterilize stones by boiling them, and to sterilize a special piece of ceremonial clay pot made during pregnancy and broken at the time of birth. Both approaches respect tradition and prevent infection.

In Africa and South Asia, premature babies often die because newborns are normally scrubbed with cold water and soap and left on a cold floor to dry. We are working to teach mothers to gently wipe babies clean, wait three days before the first bath, keep babies cuddled next to the skin and consistently breastfeed. These practices — called “skin to skin” or “kangaroo mother care” — have helped reduce death rates for premature infants by 50 percent in parts of India. In Ethiopia, we have seen similar positive results among preterm, low-birthweight babies.

Overall, 10 countries account for more than two-thirds of all the 4 million newborn deaths worldwide every year. India leads the list with more than 1 million newborn deaths per year, and China is next with 416,000. But India and China have huge populations, and their rate of newborn deaths is not the world’s highest.

The region with the highest rate of newborn death is sub-Saharan Africa, where in some countries 1 in 5 mothers has lost at least one baby in childbirth — a terrible rate of grief. So many newborns die in sub-Saharan Africa babies are often not named until a week to 40 days old.

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, though they are low-income countries. In Vietnam, girls are encouraged to stay in school so they begin having 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 space births at healthy intervals. Nearly all pregnant women get 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 start breastfeeding exclusively within an hour of delivery. In Nicaragua, nearly all women are literate and two-thirds use modern contraception.

What more can be done? In the developing world, communities are pulling together to help themselves. For example, in Mali, one of Africa’s poorest countries, grandmothers, highly respected and influential in family matters, have been enlisted to educate new mothers on the merits of breastfeeding. As a result, in many Mali communities, the number of mothers who provide babies only breast milk during the first three days after birth has increased dramatically, to the benefit of these babies.

Save the Children is encouraging governments worldwide to invest more in education and health care for girls, women and newborns, and to provide the low-cost, low-tech solutions that save lives. We know from experience these simple solutions work. Since the year 2000, Save the Children has worked in Africa, Asia and Latin America to provide newborn health and survival programs, reaching more than 20 million mothers and babies through health services.

On Mother’s Day, in addition to buying your mom chocolate, flowers and a nice card, consider visiting our Web site at www.savethechildren.org and finding out more about efforts under way to help mothers save their newborns. You can also learn about new legislation, the CHILD and Newborn Act of 2006, that would help develop an integrated strategy for improving child and maternal health and authorize increased international assistance for these programs.

For millions of mothers worldwide, helping them ensure the survival of their babies would be the greatest Mother’s Day gift of all.

Charles MacCormack is president and chief executive officer of Save the Children, an independent global humanitarian organization, based in Westport, Conn. Anne Tinker is head of the agency’s Saving Newborn Lives initiative, supported by the Bill & Melinda Gates Foundation.

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