As a general matter, you cannot directly compare the neonatal or infant mortality statistics between countries since different populations have different levels of risk. Indeed, since race is a risk factor for premature birth and poor outcomes, neonatal and infant mortality rates in first world countries tend to be a reflection of racial composition. Therefore, I was suprised to find that according to the World Health Organization, the US has one of the lowest rates of perinatal mortality in the world, despite the fact that it has a relatively high risk population compared to other first world countries.
Neonatal and Perinatal Mortality Country, Regional and Global Estimates was published by the World Health Organization in 2006. It provides detailed statistics as well as analysis and commentary. According to the WHO:
The perinatal period covers the period leading up to birth and the first week of life; deaths occurring in this period are largely due to obstetric causes... In the year 2000, over 6.3 million perinatal deaths occurred worldwide: almost all of them (98%) occurred in developing countries... More than one third of stillbirths take place intrapartum, i.e. during delivery, and are largely avoidable...For those who maintain that birth is inherently safe because it is natural, this is a dramatic refutation. In countries with limited access to modern obstetrics there are over 6 million perinatal deaths each year; that includes 2 million deaths during childbirth each year.
Complications of childbirth are the cause of almost all deaths during delivery. Intrapartum deaths are largely avoidable through appropriate care during delivery, and therefore closely related to the place of birth and the availability of qualified birth attendants...
Not surprisingly, third world nations have the highest rates of perinatal mortality. The Ivory Coast has the dubious distinction of the highest perinatal mortality rate at 96/1000. The lowest rates occur in countries that have widespread access to modern obstetrics:
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Comparing perinatal mortality rates, which the WHO believes is an indicator of obstetric care, the US is comparable to all other first world countries. This is all the more remarkable when one considers that the US has a higher risk profile than other first world countries.
This piece first appeared on Homebirth Debate in February 2007.