Washington, DC - Women in the United States face greater risks to their sexual and reproductive health than women in Singapore and many European nations. However, those risks are far less than those faced by women in Africa, according to a new study ranking 133 countries released today by Population Action International (PAI). Italy and Ethiopia are ranked lowest and highest risk respectively by the PAI study.

As the nations of the world today mark International Women's Day, PAI, a leading population policy group, and CARE, one of the world's largest international relief and development organizations, are highlighting the importance of reproductive health care in women's lives and in the battle against global poverty.

"There is a gaping chasm between rich and poor countries when it comes to the sexual and reproductive health of women," says Amy Coen, president of PAI. "Right now, in developing countries, nearly half of all women deliver their babies with no help from skilled health personnel, and there are 150 million women who say they want to prevent or delay their next pregnancy, yet do not have access to contraceptives."

PAI and CARE identify access to contraceptives, essential obstetric care, and HIV/AIDS prevention programs as three interventions key to saving the lives of women and men of reproductive age.

"The need for reproductive health care and information is shared by women everywhere, but where they live can make their experiences vastly different," explains Maurice Middleberg, director of CARE's Health and Population Unit. "In the United States, typically, a pregnant woman visits her doctor monthly, reads books about caring for herself and her baby and, if necessary, can call 911 for emergency care. After her pregnancy, she may choose a method of contraception so that her body has time to recover before another pregnancy. In stark contrast, millions of women around the world live in countries where such "basic" services are rare; their health, and that of their children, suffer."

The PAI study, A World of Difference: Sexual and Reproductive Health & Risks ranks 91 developing and 42 developed countries representing 95 percent of the world's population on a Reproductive Risk Index and places them in one of five risk categories: Very High, High, Moderate, Low and Very Low.

The 10 indicators used in the Index are births to teens and women, contraceptive use, male and female HIV/AIDS prevalence, access to skilled care in pregnancy and childbirth, deaths during pregnancy and childbirth, abortion policies, and anemia in pregnant women. The Index chart is accompanied by a booklet that addresses such critical issues as the role of men in reproductive health, violence against women and causes of infertility.

Key Findings

• Despite progress made over the past quarter century, one in every 65 women in developing countries will die from reproductive health-related causes during her lifetime, a rate 33 times higher than the risk to women in developed countries who face a one in 2,125 chance of dying.
• New estimates suggest that about 515,000 women die each year in pregnancy and childbirth, or almost one death every minute, and millions more women become ill or disabled. This new figure updates previous estimates and uses a different methodology and, in some cases, more reliable data. The new estimate confirms that maternal mortality remains a serious problem, particularly in sub-Saharan Africa where half of all deaths from pregnancy-related causes occur.
• The Index shows that nearly three-quarters of the countries in the Very High and High Risk categories are in sub-Saharan Africa. However, Afghanistan, Haiti and Laos, among others, also fall into these high-risk categories.
• Births to teenage girls-associated with higher rates of death and disability than births to older women-are highest in Angola, Niger, the Democratic Republic of Congo, Liberia and Sierra Leone, where one in five girls aged 15 to 19 give birth each year. Teen birthrates are lowest in Japan, the Koreas, Netherlands, and Switzerland, at fewer than one in 100. In the United States, one in 20 teenage girls give birth each year.
• While the United States falls into the Very Low risk category, it is ranked 15th among this category's 25 countries. The United States ranks below Singapore and just above the Czech Republic and Lithuania, two countries with far fewer resources that rank 16th and 20th respectively.

The key reason for the low U.S. ranking is that while most women in the United States have excellent prenatal care, and very few women die from pregnancy-related causes, the United States has more teenage mothers than any other industrialized country. The high incidence of adolescent births reflects a lack of reproductive health information for teens and too often leads girls to drop out of school.

Media Contact:
Leslie Isom Raabe, PAI, 202-557-3419, lisom@popact.org
Nicole King, CARE 202-595-2810, king@care.dc.org