Why women are six times more likely to die in childbirth in the UK than in Belarus

Is the UK's poor ranking in Save the Children's report linked to high levels of inequality?


Each year the charity Save The Children releases a report on the best and worst places in the world to be a mother. State of the World’s Mothers uses five indicators to rank countries: risk of dying in childbirth, under-five mortality rate, educational status, political status and economic achievement.

Britain has failed to make the top twenty on this list for the second year running, meaning it is underperforming as one of the world’s wealthiest countries. It is pushed down the list largely by the political indicator, on which it ranked 63rd due to the poor representation of women in government.

What is even more concerning is the fact that researchers at Save The Children calculated that women in the UK are twice as likely to die in childbirth as women in Poland or Austria. A UK woman has a one in 6,900 lifetime risk of maternal death, compared to one in 19,800 in Poland, one in 19,200 in Austria and one in 45,200 in Belarus.

The US has the highest maternal mortality rate of any developed country in the world, with a one in 1,800 lifetime risk of maternal death – worse than Iran (2,000) and Saudi Arabia (2,200), countries which do much worse on other indicators. For example in Iran, only 3.1 per cent of government seats are held by women, compared to 19.5 in the USA. The gross national income of Saudi Arabia is less than half that of the US.

Inequality could be a key factor in the relatively low placements of the US and UK on the scale. The top five spots were all occupied by Nordic countries, with Norway ranked best in the world, followed by Finland, Iceland, Denmark and Sweden. These are all countries with small income disparities, with very low scores on the Gini- coefficient for inequality. Sweden’s most recent measure is 0.25, compared to 0.38 for the UK. The US is on 0.41. Belarus also has a low score, at 0.27.

Obesity, social deprivation, multiple pregnancies and poorer access to healthcare are associated with income inequality in the UK. These in turn are linked to high-risk pregnancies, including in ethnic minority communities. The shocking differences between life expectancies in general in the UK – by some ONS measures men in the most advantaged areas can expect to live 19.3 years longer in ‘good’ health than those in the least advantaged areas – point to vast gulfs in the healthcare available to different sections of society.

Save The Children’s study looks at the different life chances of urban rich and poor in developing countries, and finds that in many of these countries people who move to the city in search of a better life often find themselves in greater hardship than before. In rapidly growing cities, it is survival of the richest, with large and growing urban child survival gaps. In Bangladesh, Cambodia, Ghana, India, Kenya, Madagascar, Nigeria, Peru, Rwanda, Vietnam and Zimbabwe. In these countries, the poorest urban children are three to five times more likely to die before the age of five than their richest peers. High death rates in slums are linked to overcrowding, poor sanitation, disease, discrimination and violence.

There are different factors at play in developed countries, although the survival gap is no less striking. Babies in Washington DC’s Ward 8, where over half of all children live in poverty, are about 10 times as likely as babies in Ward 3, the richest part of the city, to die before their first birthday.

The report does not analyse in-depth its findings in the UK. But based on analysis of other countries, I’d guess that survival gaps will be geographically distributed in a way which correlates with areas of social deprivation and low income. The shameful fact that in today’s Britain, life chances are still very much determined by postcode.

Ruby Stockham is a staff writer at Left Foot Forward. Follow her on Twitter

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