The international child development and relief organization Save the Children (STC) recently launched a major campaign to increase Americans' awareness of the "inextricable link between mothers' and children's well-being." In a series of television and print advertisements and community outreach activities, the Every Mother/Every Child campaign identifies family planning as one of four key health components in securing maternal well-being and child survival worldwide. According to STC, expanded access to contraception would save an estimated three million children's lives every year simply by allowing mothers to space their pregnancies at least two years apart.

At the center of STC's campaign is its State of the World's Mothers 2001 report, which ranks various countries' "investment" in mothers and girls by examining such outcome indicators as women's access to health care and education levels. In the STC mothers' index, the United States, although the world's wealthiest nation, ranked 11th out of 94 countries (see chart). The main reason for its low standing was its maternal mortality rate—one in 3,500 American women risk dying from pregnancy and childbirth over their lifetime, placing the United States behind northern European countries and fellow English-speaking ones, such as Australia, Canada and the United Kingdom. (Overall, the United States would likely have performed even worse if the STC mothers' survey had included other key industrialized countries, such as France, Germany and Japan.)

The STC girls' index examined female child mortality, girls' access to education and teenage birthrates in 140 countries. Despite its low infant and child mortality rates and equal levels of education among girls and boys, the United States came in 22nd place. What hurt the United States was its high teenage birthrate, cited as 59 births per 1,000 women aged 15-19. When STC compared teenage birthrates in the 140 countries, the United States placed in the bottom half—in 75th place behind numerous developing countries, such as Algeria and Cambodia.

The status of women and children in the world today is grim: Every year, notes STC, more than 500,000 women—at least one every minute—die from pregnancy-related causes that are usually highly treatable. Every day, 31,000 children younger than five die, often because of complications that date back to pregnancy. Accordingly, STC is calling for a multipronged solution to improving the lives of women and children, including greater access to education for girls, improved economic opportunities for women, policies that protect women and girls from gender-based violence and HIV/AIDS, and expanded family planning services. If the United States is serious about its commitment to reduce maternal and child mortality rates both at home and abroad, says STC, it must do more to ensure that contraception is available and affordable to women regardless of age or income level. Domestically, that would lower the teen pregnancy rate and birthrate. Internationally, it would help answer the call of the 150 million married women from developing nations who want contraception but cannot obtain or afford it.

—V. Lin