Speaking of : Worldwide Hazards of Childbirth

Birth is a natural event taken for granted in most developed nations. But, for millions elsewhere, it can be a fearful and dangerous experience.

About 1.3 million women around the world die every year from reproductive health-related causes, according to a survey of 118 nations just released by Population Action International in Washington. Most of them come from societies that cannot afford to provide basic health care during pregnancy and childbirth; family planning may be unavailable.

The contrasts between rich and poor can be heartbreaking. In Zaire, the risk of dying from various maternal causes is almost a thousand times greater than in Italy. Still, there are bright spots. Worldwide, women’s health has generally improved with the trend toward smaller families and better access to education, birth control and health care. Teen birthrates in Japan, for instance, are near zero.

REPRODUCTIVE RISK

Nations are rated based on factors in tables, lower right

* VERY LOW

23 countries

Regions: North America, Europe, Australia.

Characteristics: Relative wealth, low overall fertility, high contraceptive use, liberal abortion policies.

* LOW

20 countries

Regions: Eastern Europe, lower South America.

Characteristics: similar to preceding category, but with a higher maternal mortality.

* MODERATE

29 countries

Regions: Central and upper South America, Middle East.

Characteristics: Moderate use of contraceptives, high maternal mortality. Abortion is either illegal or available only on a limited basis in most of these countries.

* HIGH

25 countries

Regions: Africa

Characteristics: High teen birthrate, overall fertility rate and maternal mortality. Maternal health coverage is generally poor and HIV prevalent among women.

* VERY HIGH

21 countries

Regions: Africa

Characteristics: Negligible contraceptive use, extremely high maternal death rate, high STD-related infertility, restrictive abortion policies and moderate HIV infection in women.

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Country: ITALY

Annual births per 100 women aged 15-19: 1

Women using contraception (%): 78

Abortion policies*: A

Infertility in women (%): 6

Average births per woman: 1.2

Maternal deaths per 100,000 births: 4

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Country: JAPAN

Annual births per 100 women aged 15-19: 0

Women using contraception (%): 64

Abortion policies*: B

Infertility in women (%): 6

Average births per woman: 1.5

Maternal deaths per 100,000 births: 11

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Country: U.S.

Annual births per 100 women aged 15-19: 6

Women using contraception (%): 71

Abortion policies*: A

Infertility in women (%): 6

Average births per woman: 2.1

Maternal deaths per 100,000 births: 7

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Country: ISRAEL

Annual births per 100 women aged 15-19: 2

Women using contraception (%): 65

Abortion policies*: C

Infertility in women (%): 6

Average births per woman: 2.9

Maternal deaths per 100,000 births: 3

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Country: SOUTH KOREA

Annual births per 100 women aged 15-19: 1

Women using contraception (%): 79

Abortion policies*: C

Infertility in women (%): 2

Average births per woman: 1.6

Maternal deaths per 100,000 births: 32

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Country: ARGENTINA

Annual births per 100 women aged 15-19: 6

Women using contraception (%): 66

Abortion policies*: C

Infertility in women (%): 3

Average births per woman: 2.9

Maternal deaths per 100,000 births: 140

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Country: SAUDI ARABIA

Annual births per 100 women aged 15-19: 12

Women using contraception (%): 14

Abortion policies*: C

Infertility in women (%): 3

Average births per woman: 5.5

Maternal deaths per 100,000 births: 41

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Country: MEXICO

Annual births per 100 women aged 15-19: 8

Women using contraception (%): 53

Abortion policies*: D

Infertility in women (%): 3

Average births per woman: 3.2

Maternal deaths per 100,000 births: 200

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Country: INDIA

Annual births per 100 women aged 15-19: 6

Women using contraception (%): 41

Abortion policies*: B

Infertility in women (%): 3

Average births per woman: 3.4

Maternal deaths per 100,000 births: 420

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Country: INDONESIA

Annual births per 100 women aged 15-19: 6

Women using contraception (%): 55

Abortion policies*: E

Infertility in women (%): 7

Average births per woman: 2.9

Maternal deaths per 100,000 births: 400

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Country: GUATEMALA

Annual births per 100 women aged 15-19: 12

Women using contraception (%): 23

Abortion policies*: E

Infertility in women (%): 3

Average births per woman: 5.4

Maternal deaths per 100,000 births: 300

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Country: KENYA

Annual births per 100 women aged 15-19: 14

Women using contraception (%): 33

Abortion policies*: E

Infertility in women (%): 7

Average births per woman: 5.4

Maternal deaths per 100,000 births: 500

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Country: HAITI

Annual births per 100 women aged 15-19: 5

Women using contraception (%): 10

Abortion policies*: E

Infertility in women (%): 7

Average births per woman: 5.8

Maternal deaths per 100,000 births: 600

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Country: ETHIOPIA

Annual births per 100 women aged 15-19: 17

Women using contraception (%): 4

Abortion policies*: C

Infertility in women (%): 10

Average births per woman: 6.9

Maternal deaths per 100,000 births: 900

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Country: ZAIRE

Annual births per 100 women aged 15-19: 23

Women using contraception (%): 8

Abortion policies*: E

Infertility in women (%): 21

Average births per woman: 6.7

Maternal deaths per 100,000 births: 800

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* Key to Abortion Policies

A: available on request

B: permitted on broad social, health grounds

C: permitted on limited health grounds

D: permitted only for special cases (rape, incest, save a woman’s life)

E: illegal

Death Risk

Chance of a woman dying from complications of pregnancy, childbirth or unsafe abortion during her lifetime: Italy: 1 in 17,361 Norway: 15,432 United States: 5,699 Poland: 3,608 Cuba: 1,286 China: 439 Zimbabwe: 217 Mexico: 131 India: 69 Kenya: 31 Mali: 7

SOURCES: Population Action International, which drew info from: World Health Organization (WHO) database; World Development Report, 1993; Human Development Report, 1994; State of the World’s Children Report, 1995

Compiled by Times researcher JOHN MAKNIC