U.S. Top of List for First-Day Deaths in Rich Nations

More babies die on their first day of life in the United States than in any other industrialized country.

Ryan and Sandra Doherty cuddle the blanket that their daughter was placed in after a stillborn delivery.


The United States has the highest rate of first-day deaths in babies than any other industrialized nation, according to a report released this week by the humanitarian group Save the Children.

Throughout the world, the first day of life is the most hazardous time for a baby; just over one million children die each year within 24 hours of being born.

Save the Children's annual "State of the World's Mothers" report ranks 176 countries on levels of well-being among children and mothers. This year's edition puts a special emphasis on newborn health, featuring its first-ever Birth Day Risk Index. The index ranks countries from the safest to the most dangerous for a baby to be born in.

In the United States, babies are 50 percent more likely to die on the same day they were born than in all of the other industrialized countries combined, according to the report. Each year, nearly 11,300 babies die on the day they were born in the United States, making American babies twice as likely to die in their first 24 hours as European Union babies.

Why the Gap?

The findings don't surprise Save the Children president and CEO Carolyn Miles, who said in an e-mail interview that the U.S. consistently has a preterm birth rate far above those of other industrialized countries.

Its high rate of premature births and its large population may partially explain why the U.S. tops other industrialized nations in first-day deaths for babies. Factors like poverty, stress, and teenage pregnancy also play a role, Miles said.

Babies born to the poorest mothers are 40 percent more likely to die than babies born to wealthy mothers, said Miles.

"African-American women face much greater risks, and there are also reasons relating to chronic health conditions and obesity, to older mothers, to elective C-sections," she said.

The health dangers that poor and minority women face—like a high rate of premature birth and low birth weights—are compounded by the difficulties they have getting high-risk care in the United States, Miles said.

But questions remain about why the United States is in a league of its own for first-day deaths. "We can really only explain about half of the discrepancy," Miles said, "and more research is needed."

Developing Nations

Fixing the problem, according to Save the Children, rides largely on education and access to medical care.

"It comes down to making sure all women can access health services before and during pregnancy," Miles said. Save the Children is calling on Congress to establish a new National Commission on Children to address the issues that children in poverty face every day—in the United States and in developing countries.

Those countries see the vast majority of first-day deaths, due to factors like birth complications and infections, which rarely cause death in babies in rich countries, according to the Save the Children report. Only 1 percent of the world's newborn deaths occur in industrialized countries.

The United States places 30th in overall best conditions for mother and baby, according to the Save the Children index. The Democratic Republic of the Congo is at the bottom of the list.