The State Of Motherhood In 2018: The Best (And Worst) Countries For Moms Around The World

From tiger moms to French food philosophies, here’s what American moms can learn from parenting around the world.

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March 11, 2018
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For the first month after Charlotte Edwards gave birth, she was confined to her home. No computer. No stepping outside. No doing laundry. Her father-in-law grocery shopped and washed her baby’s clothes (by hand). Her mother-in-law cooked and helped with the baby’s every need.

No, Edwards didn’t land in in-law heaven. This is tradition in China, where zuoyuezi, which literally means “sitting a month,” is observed by every mom…and in-laws are typically the ones who pitch in to make it happen.

And yet, when policy experts tally up various facts and figures, China doesn’t take the prize for “best place in the world to be a mom” (that honor goes to Iceland). Nor is it at the top of the best places to raise kids ranking (another Scandinavian country grabs that distinction).

We’re not going to steal work from the policy wonks out there who draw up these lists every year, but we wondered if there wasn’t something to learn from the way parenting is done and mothers are treated around the world.

Can we improve motherhood right here in the U.S. by picking and choosing some of the offerings from other countries? Or simply attain more appreciation for what we have?

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From the looks of the parenting books pushed out of publishing houses in recent decades, that’s exactly what an increasing number of moms are trying to do.

Amy Chua’s controversial 2011 parenting memoir Battle Hymn of the Tiger Mother gave us a how-to for parenting like a mom from China does. Though Chua herself is American—born in Illinois to parents who immigrated to the U.S.—her guide was quickly followed by tomes on how kids around the world get their smarts, tutorials on raising better eaters by pretending to be French, and, most recently, a German parenting waltz that shares its name with a hit U2 album.

As Brooklyn-based writer Catherine Crawford, whose adventures in parenting her two daughters like a French mom inspired her book French Twist: An American Mom’s Adventure in Parisian Parenting, tells HealthyWay, “The fact that we have so many ideas and approaches to borrow from is both lucky and unlucky. Choice is wonderful, but it can be overwhelming.”

So how do you choose? How do you know if you’re buying into the notion that the grass is always greener or truly finding inspiration in the right places? Let’s dive in.

Pregnancy Around the World

The parenting journey starts with pregnancy. Whether you give birth to your children or adopt, someone somewhere has to get pregnant.

Living in the land of the free and the home of the brave has its drawbacks here. A recent State of the World’s Mothers report by the charity Save the Children puts the United States dead last on a ranking of maternal health for moms in developed countries. Here in the U.S., a woman expecting a baby faces a 1 in 1,800 risk of maternal death.

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The best places to live if you’re expecting a baby? If you can handle the winters, Scandinavia is the perfect place to gestate your little one. Norway takes the top spot on the Save the Children list, followed by Finland, Iceland, and Denmark, with Sweden rounding out the top five.

The hardest places to be pregnant are all on the African continent, with Somalia ranked at the very bottom, just below the Democratic Republic of Congo. In countries on that end of the spectrum, Save the Children estimates an average of 1 in 30 women will die from a pregnancy-related complication.

So what makes it so much harder to be a mom in one area of the world versus another?

Poverty and wealth play clear roles. The countries where moms struggle the most also tend to be some of the poorest in the world.

But what countries on the higher end of the spectrum all have in common is a focus on prenatal care, which ensures they have not only healthy moms but healthy babies.

Norway, for example, boasts one of the best healthcare systems in the world. (And you don’t have to take the Norwegians’ word for it: The World Health Organization agrees.)

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The land of fjords, trolls, and Norse mythology is also home to svangerskapskontroll, also known as regular prenatal check-ups that are covered in full by the country’s universal healthcare. Norway also offers a maternity leave plan that extends for 49 weeks at full pay (or 59 weeks at 80 percent pay). Moms can choose between a midwife or an obstetrician, and their choices during their graviditet (Norwegian for pregnancy) guide the entire nine months. If a mom doesn’t want a test done, she says no.

Moving down the list a bit is New Zealand, which lands at No. 17 on Save the Children’s index. Kiwi mom Margo Marshall tells HealthyWay that midwives care for moms with regular (not high-risk) pregnancies from the time pregnancy is confirmed through week six postpartum.

“Prenatal care is as non-invasive as possible,” Marshall says. “So whilst we do refer for standard scans at 13 weeks (for chromosome abnormality detection) and at 20ish weeks (for anatomy scan) that’s all the routine scans that are offered unless clinical needs suggest otherwise.”

Not surprisingly, midwifery care has been linked by a number of studies to improved outcomes for moms, which is reason enough for this to be considered a perk of living down under, but Marshall says there’s another advantage, too.

“All of this is free to the mother, courtesy of global health care,” she notes. “It’s possible to opt to have an obstetrician look after your care, but only a small minority do so. This usually comes with a couple thousand in extra fees (because unless referred for a clinical reason, it’s considered ‘going private’), and the general feel is that an obstetrician in charge of maternity care for a normal, straightforward pregnancy is overkill.”

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Wondering where else you can have a dream-like pregnancy (or not)? Here are some of the wins and hits moms take in other countries:

  • In Japan, the mysteries of pregnancy aren’t left to the parenting books. The government offers women a special pregnancy handbook, which guides them through the process. Each expectant mother also receives a Maternity Mark, a special emblem moms can carry on keychains or bags that signals to society that they’re gestating and should receive kind treatment.
  • In Tanzania, maternal mortality rates are among the world’s highest, with 454 maternal deaths per 100,000 live births. One of the biggest problems Tanzanians face is inadequate prenatal care. In this East African nation, only 15 percent of women seek out a doctor’s care during their first trimester. To combat that, health workers have created special awareness programs to convince moms to initiate prenatal care earlier. If they do go to the doctor, they’ll find one thing most American moms won’t: The average first-time prenatal visit in Tanzania lasts a whole 46 minutes.
  • In China, Edwards found that moms don’t make prenatal appointments. Instead they line up at the doctor’s office and wait to be seen. “Because of this, we found a friend who would help and see me when she worked the night shift,” Edwards says of her pregnancies. Another concern she noted are Chinese legends surrounding pregnancy: “There are still many old wives’ tales that are followed like it’s the gospel truth,” she notes. “Sex is forbidden during the first and third trimesters because it’s believed to cause miscarriage. Women cut their hair short so the baby gets more nutrition.”

Birth: Who Gets It Right

Even if you’re having a marvelous pregnancy with plenty of pampering, eventually that baby has to come out.

If you plan to give birth in the United States, the numbers allude to an alarming tale. America’s infant mortality rate sits at 5.8 deaths per 1,000 births. That’s more than double the rates in Japan and Sweden, the countries with the lowest infant mortality rates in the world.

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When Save the Children’s researchers took a look at capital cities in high-income countries, Washington, D.C., ranked the highest for infant death risk, with an infant mortality rate of 6.6 deaths per 1,000 live births. Those figures, which come from 2013, represented an all-time low for our nation’s capital, and yet they’re still three times higher than infant mortality rates in Japan’s capital, Tokyo, or Stockholm, the capital of Sweden. What’s more, they’re not the worst in the United States. Detroit’s infant mortality rate was reported at 12.4. In Cleveland, the figure jumped up to 14.1.

But before you start packing your bags to head out of the country, it’s important to note that infant mortality rates are declining in the United States, as is the number of babies born to teen moms.

What’s more, American moms are still at a vast advantage, as the U.S. comes in at No. 24 on the Save the Children list of best and worst places to give birth. By comparison, Haiti and Sierra Leone are tied for 170th on that list.

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Here are some other birthing practices that impact delivery around the world:

  • Exhausted after you give birth? Join the club. But if you want a little time to recover before you’re thrust into the world with your baby, your best bet is to deliver at a Ukrainian hospital. Moms there spend an average of 6.2 days in the hospital after birth. Egyptian moms, on the other hand, typically check out after just half a day.
  • In Belgium, you can choose any name you like for your child, but beware! The government has the authority to make you change it! The government may weigh in on names that seem to cross gender barriers, sound “ridiculous,” or that an official deems offensive. If parents are dead set on the name, they may wind up in court appealing the official decision.
  • Home birth is illegal in some countries and can even get midwives arrested in some parts of the United States. But if you have your heart set on delivering in the comfort of your own digs, you may want to learn Dutch. The Netherlands boasts the largest number of home births in the Western world, with a third of moms bringing their babies into the world at home.

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Bringing Up Baby

Like pregnancy and birth before them, moms in different countries might as well be living on different planets when it comes to how they spend the days and months after giving birth.

Edwards, for instance, was at home being pampered by her in-laws. But unlike relatives in the United States who were instructed to head back to the obstetrician’s office for post-natal care within two months, she received no medical postpartum care in China. She also wasn’t expected to take her kids to the pediatrician for what American moms consider traditional check-ups.

That Chinese approach has its drawbacks, Edwards says, but some of the benefits are hard to ignore (including the benefits to a mom’s health).

As frustrating as it was to not be allowed to have cold things, wash my hair (I did break that rule after a week), go outside, use the computer, it was nice to have the freedom to just rest,” she recalls. “My father-in-law shopped for foods and washed baby clothes (by hand; it’s considered more sanitary) and [my] mother-in-law cooked and helped with baby. All the nutritious meals and sleep helped me to lose all my baby weight—plus another 10 pounds—by the end of the month.”

In New Zealand, moms like Marshall qualify for visits from their midwives after they’re discharged from the hospital, beginning with a practitioner swinging by a mom’s home daily for the first two to three days, then every few days, then weekly until a mom is six weeks postpartum.

After that, Marshall says, many moms qualify for care under Plunket, a government-sponsored program that provides well-child checks with a registered nurse who will answer parents’ questions about everything from infant health to parenting practices.

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Of course postpartum care isn’t just medical. With the exception of the United States, paid maternity leave is guaranteed throughout the Western world, although how much and who gets it varies from place to place. In most countries with paid leave, just 1 in 5 dads gets some sort of benefit, while in places like Australia, it’s just 1 in 50.

Dads in Scandinavia tend to get the best chance at being physically present during their babies’ formative years. A full 40 percent of fathers take time off to relieve new mothers of some of the childcare burden, and they do so with the government’s blessing. In Denmark, for example, moms and their partners can split 32 weeks worth of paid leave so that between them, two parents can cover the first several years at home with a child without having to sacrifice their earnings.

But even in places where fathers are guaranteed leave, they’re not always comfortable making the most of it. Japanese fathers have a full year’s worth of time off that’s protected by their government, but it’s rare for them to take it.

Meanwhile, many moms in the U.S. aren’t even guaranteed a paycheck—nor do all employers have to hold women’s jobs for them if they take time off to give birth and establish breastfeeding routines. The Family Medical Leave Act (FMLA) guarantees moms up to 12 weeks off after birth, adoption, or a foster care placement, but it doesn’t require employers to pay moms during that time. It also exempts any company that has fewer than 50 employees, meaning thousands of American businesses can legally fire a woman who wants to take a few days off to recover from birth. As for partners, the FMLA does recognize dads and same-sex partners, but it still lacks teeth when it comes to requiring payment and loses power due to the exemptions it affords a large sector of businesses.

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So what’s that first year like around the world?

  • In China, moms like Edwards practice elimination communication—an infant-led “potty training”—whereby moms hold their young ones over a toilet rather than depending on diapers.
  • In Brazil, strict laws that limit how formula companies can advertise their wares are one of the many ways the government supports moms in breastfeeding. The country also boasts the largest number of human milk banks in the world, offering options to moms who are struggling with breastfeeding or who can’t or don’t want to breastfeed.

Growing Up Globally

So what’s it like raising a child in different parts of the world? Ask any mom, and you’ll get a different story, which can also be true of two parents who live in the exact same town in America but have different income levels, cultural backgrounds, and daily experiences.

Still, there are some distinct country-dependent differences in parenting styles and in how kids are treated. In addition to their considerations of moms and motherhood, Save the Children’s researchers have spent time around the world researching where kids have it best…and where they have it worst.

Countries wracked by poverty and war unsurprisingly fall low on the list, while the Nordic countries, with their focus on healthcare and education for all, are situated near the top. The researchers note that the highest rates of child mortality are found in sub-Saharan Africa, where basic medical care is often unavailable, too far away, or too expensive, and kids are also more likely to be born to mothers with limited education. Lack of education traps people in poverty, hurting moms and kids alike.

But even in the Western world, where kids usually have a more level playing field, there are disparities.

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In the United Kingdom, parents are spending a third of their annual salaries on childcare, with American parents—who spend a quarter of their incomes on childcare—not far behind. Korean moms have it made in the shade on this account, though: Their government foots the bill for daycare.

As for education, U.S. parents have to funnel away a whole lot of dough if we want our kids to see the inside of a college classroom. Our tuition rates are highest in the world, while many Scandinavian countries offer kids a chance at higher ed for absolutely nothing.

Here’s more on what it’s like to raise a kid around the world:

  • In conducting the research for her book, Crawford found that French moms readily assume their role as the boss, rather than allowing their kids to wear them down. “This was huge in cutting down on the negotiating and bargaining that usually just ended up in crying,” she recalls. “When I told my kids that I was the undisputed decision maker and no amount of whining would change that, everyone relaxed. It makes sense. A 35-year-old makes better decisions than a 2-year-old.”
  • Mommy’s Netflix time after the kids go to sleep may be popular in America, but in places like Spain and Argentina, kids typically stay up until at least 10 p.m. in order to spend more time with their families.

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