Surviving the First Day: State of the World’s Mothers 2013

This year’s State of the World’s Mothers report shows which countries are succeeding – and which are failing – in saving the lives of mothers and their newborn babies. The key take away? More than 1 million babies die on the first day of life – making the birth day the most dangerous day for babies in nearly every country, rich and poor alike.

6.9 million 




3 million


That’s how many children under 5 die each year... a decrease of over 40% since 12 million died in 1990.


From 543,000 maternal deaths in 1990 to 287,000 in 2011, that’s a decline of almost 50%.


In 2011, 3 million babies died in their first month of life. This is 43 percent of all deaths of children under age 5 worldwide. Three-quarters of those newborns died in the first week of their lives, and one-third did not survive their first day of life.

Navigate the report below (or download it here):


For the most vulnerable, there is still a lot of work to be done.

Newborn deaths are not inevitable – and low-income countries can make significant progress in reducing newborn mortality. In our report, we identify the three major causes of these deaths – complications during birth, prematurity and infections – and explain a set of interventions we’ve developed that can prevent or treat each of these causes.

These proven interventions – coupled with stronger health systems– have the potential to reduce newborn deaths by as much as 75 percent. This would save more than 2 million newborn lives each year.

The Best and Worst Countries to be a Mother

The contrast between the top-ranked country, Finland, and the lowest-ranked country, Democratic Republic of the Congo, is striking. Maternal death is a rare event in Finland (a woman has less than a 1 in 12,000 chance of dying in pregnancy or childbirth). But in DR Congo, 1 woman in 30 is likely to die of a maternal cause. Children in DR Congo face similarly poor odds: 1 in 6 Congolese children don’t live to see their fifth birthday. In Finland, only 1 child in 345 doesn’t survive his or her first five years. At these rates, 9 out of 10 women in DR Congo are likely to lose a child under age 5, whereas only 1 in 181 Finnish women is likely to suffer the loss of a child in her lifetime.

Canada’s Rank

Compared to top-ranked countries, Canada (22 on the Mothers’ Index) could be doing a lot better.

While the United States has the highest first-day death rate in the industrialised world, Canada and Switzerland have the second and third highest rates, respectively. Newborns in these three countries are at least 4 times as likely to die on the day they are born as babies born in the lowest mortality countries where first-day death rates are at or below 0.5 per 1,000 live births.

While the data are not conclusive, it is clear that significantly higher child mortality rates in the remote north contribute to Canada’s lower ranking. More research still needs to be done to determine the precise causes for these rates – and for the regional variation one finds across the country – so that proper public health policies and investments in health systems can be implemented. Save the Children strongly believes that Canada should – and has the capacity to – do much better to support newborn lives. Read more on our work with Indigenous Communities here.


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