172 Best (& Worst) Countries for Pregnant Mothers in 2022

We ranked 172 countries with available data to find the best and the worst countries for pregnant mothers in 2022. We scored these countries using eight different ranking factors, including the number of nurses and midwives for every 1,000 people, the percentage of pregnant women receiving prenatal care, the percentage of total births attended by skilled health staff, infant and maternal mortality rates, the prevalence of congenital disabilities, access to safe and federally protected abortion options, and the number of weeks of maternity leave offered. All scores for these factors were given full weight (100 points), as each is critical to a successful, healthy, and comfortable pregnancy. We utilized a mixed methods research design to create the index. The highest possible score is 800 and the lowest possible score is 0.

Ranking factors

• Nurses and midwives per 1,000 people (0 to 100 points) — Information about the rates of nurses and midwives per thousand people was obtained from the World Health Organization and supplemented by WorldBank. The more nurses and midwives a country has relative to its population, the more points it received in our index.

  Sources: World Health Organization, WorldBank

• Percentage of pregnant women receiving prenatal care (0 to 100 points) — Data was obtained from UNICEF (Table 3. Maternal and Newborn Health) and supplemented by WorldBank. The higher the percentage of women who receive prenatal medical care, the more points were awarded in our index.

  Sources: UNICEF, WorldBank

• Percentage of total births attended by skilled health staff (0 to 100 points) — Data for this metric was obtained from the World Health Organization, United Nations Population Fund, and supplemented by the WorldBank. We gave higher scores to countries where more women had access to skilled health staff during birth.

  Sources: World Health Organization, United Nations, WorldBank

• Infant mortality rate per 1,000 live births (0 to 100 points) — We obtained the infant mortality rates per thousand live births from the CIA World Factbook. Lower rates of infant mortality meant higher points in our index.

  Source: CIA World Factbook

• Maternal mortality rate per 100,000 live births (0 to 100 points) — Statistics on maternal mortality rates were obtained by the CIA World Factbook. Instances of higher maternal mortality rates meant fewer points in our index.

  Source: CIA World Factbook

• Birth defects prevalence per 1,000 live births (0 to 100 points) — Data for this metric was obtained from the March of Dimes Global Report on Birth Defects. Higher instances of birth defects meant lower points in our Global Maternity Index.

  Source: March of Dimes

• Weeks of maternity leave (0 to 100 points) — Data for this metric was obtained from the OECD Parental Leave Systems and the United Nations. Scores were based on full-week income equivalent rates to standardize the rankings. For example, 52 weeks at 80% would be considered 41.6 full weeks. The more weeks a new mother is given with her child post-pregnancy, the more points we gave the country in our index.

  Sources: OECD, United Nations

• Access to federally-protected safe and legal abortion (0 to 100 Points) — We obtained this data from the Center for Reproductive Right’s World’s Abortion Laws map. Points were determined by the gestational limits within a country if available on request. Many countries only allow abortion in the event of a life-threatening emergency, and some prohibit abortion altogether. Countries with higher access to abortions were given more points in our index.

  Source: Center for Reproductive Rights

Limitations

Our study originally included two additional factors:

• The percentage of unnecessary cesarean sections
• The prevalence of postpartum depression

Unfortunately, we had to remove these sections due to insufficient country reporting. Only 65 countries report on unnecessary C-sections, and only 38 countries report on instances of postpartum depression.

The best country for pregnant mothers (according to our index) is Norway, which scored an A+. Norway had the lowest maternal mortality rate and a very low infant mortality rate. 100% of their pregnant women receive prenatal care. The nation has one of the highest numbers of nurses and midwives per 1,000 people. Norway narrowly scored higher than the next highest country, Finland, which also consistently demonstrates exceptional support for expectant moms.

Unsurprisingly, Norway and Finland were also among the top countries for raising a family (based on our other study). Scandinavia is famous for providing social benefits for its citizens, and this is clearly felt for expectant mothers.

Here are the top 25 countries:

1. Norway (A+)
2. Finland (A+)
3. Iceland (A+)
4. Italy (A)
5. Slovenia (A)
6. Czech Republic (A)
7. Sweden (A)
8. Belgium (A)
9. Singapore (A)
10. Netherlands (A)
11. Switzerland (A)
12. France (A)
13. Germany (A)
14. Austria (A)
15. Spain (A)
16. Luxembourg (A)
17. Ireland (A)
18. Australia (A)
19. Poland (A)
20. Japan (A)
21. Macedonia (A-)
22. Greece (A-)
23. Israel (A-)
24. Denmark (A-)
25. New Zealand (A-)

The worst country for pregnant mothers is Somalia, which scored an F. Somalia had the second-highest infant mortality rate as well as one of the highest maternal mortality rates. They have the lowest percentage of births attended by skilled healthcare staff at only 32% and only 0.1 nurses or midwives per 1,000 citizens. Only 31% of women attend prenatal care visits. Somalia has the second-lowest GDP in the world, making its lack of adequate healthcare resources for pregnant mothers saddening but not surprising.

Here are the lowest ranking 25 countries:

1. Somalia (F)
2. Yemen (F)
3. Nigeria (F)
4. Haiti (F)
5. Central African Republic (F)
6. Laos (F)
7. Chad (F)
8. Afghanistan (F)
9. Madagascar (D-)
10. Papua New Guinea (D-)
11. Sudan (D-)
12. Guinea-Bissau (D-)
13. Bangladesh (D-)
14. Mauritania (D-)
15. Niger (D-)
16. Angola (D-)
17. Mali (D-)
18. Ethiopia (D-)
19. Senegal (D-)
20. Sierra Leone (D-)
21. Eritrea (D-)
22. Guinea (D-)
23. Iraq (D-)
24. Republic of the Congo (D-)
25. Suriname (D-)

Some may be surprised to see the United States so low in the index at number 42 especially considering it has the highest GDP of any country in the world. It seems like an error. However, a major factor for the lower than expected ranking is due to the fact that the United States does not have nationally mandated paid leave for mothers.

It’s estimated that only 21% of U.S. employees have access to maternity leave through their employers. And the average for those that receive paid parental leave is only 4 weeks. The Family and Medical Leave Act guarantees mothers 12 weeks of unpaid leave (and is only required in companies with 50+ employees, as well as additional restrictions for eligibility). Additionally, these limitations disproportionately affect women of color.

Nine states (and the District of Columbia) have mandatory paid leave for new mothers. However, two of these states won’t offer paid leave to their residents until at least 2023. Benefits in these countries are also typically considerably lower than in equivalent countries with nationally mandated employee benefits.

The United States leaves much to be desired for its pregnant, working mothers. This lack of mandated leave for mothers leaves women even more susceptible to the  “Motherhood Penalty.”

165 countries globally have some legislation allowing for legal abortion. In fact, since Roe v. Wade was overturned on June 24, 2022, the United States joins only a handful of countries where there are no federal protections for a woman’s right to choose on a federal level.

Tedros Adhanom Ghebreyesus, head of the WHO, has recently stated, “access to safe abortion saves lives.” Abortions will happen regardless of their legal status, but legal abortions will ensure that those procedures are overseen safely. Illegal abortions are devastatingly unsafe and can lead to serious complications for the woman. Human Rights Watch recently stated, “In countries across the world, including Romania, South Africa, El Salvador, and Ecuador, there is a statistical relationship between restrictive abortion legislation and increases in maternal mortality and morbidity.”

Many abortions are medically necessary, which makes their criminalization more alarming. Whether it’s an ectopic pregnancy, an infection that leads to sepsis and death, or a placenta that erupts, medical professionals are clear: abortion is often a mandatory procedure to keep the mother alive.

The Center for Reproductive Rights calls Roe v. Wade’s overturn a “public health emergency.” Abortion no longer being federally protected now opens the floodgates for states to make increasingly restrictive legislation that will further continue to harm women’s access to reproductive healthcare.

We noticed during this study that the highest rates of birth defects seem to concentrate in the Middle East/North African (MENA) region (rates per 1,000 live births):

1. Sudan: 82.0
2. Saudi Arabia: 81.3
3. Benin: 77.9
4. Burkina Faso: 77.0
5. United Arab Emirates: 75.9
6. Tajikistan: 75.2
7. Iraq: 75.2
8. Kuwait: 74.9
9. Afghanistan: 74.9
10. Oman:  74.8

These rates are alarmingly high–almost double the rates of other countries. We looked into it further and discovered the two leading reasons for why this is likely occurring.

1. Inter-family marriage

Marriage within families (or, consanguineous marriage) is still quite common within the Middle East, occurring in up to 20-70% of marriages depending on the region and community. Saudi Arabia, for example, is known to have much higher rates of consanguineous marriage and has the 2nd highest prevalence of birth defects, according to our study. Likewise, Sudan has high consanguineous marriage rates, making up 44.2-63.3% of marriages. They have the highest rates of birth defects in the world.

More sources: 

• Keeping it in the family – The Economist
• Consanguinity and reproductive health among Arabs – NCBI
• Why cousin marriages can wreak genetic havoc on children – Genetic Literacy Project

2. Environmental effects of war

The residual effects of chemicals used in military warfare are a major cause of birth defects in many MENA countries and can be traced back to ongoing wars in the region. Chemical pollution remains a crisis in the Middle East, and it causes untold harm to the civilians living there. Chemicals like Sarin and chlorine gas do intense damage to developing fetuses, causing the prevalence of birth defects to increase dramatically.

More sources:

• Genetic disorders afflict Arab world – The National News
• The Less Obvious Effects of War in the Arab World: Birth Defects

Let’s take a closer look at the seven factors used to determine which countries were the best and the worst for pregnant mothers and some of the countries that ranked at the top and bottom for these important factors.

Number of nurses and midwives

An essential aspect of pregnancy is having enough support from the nurses and midwives who will be there for you before and during the delivery, especially if complications should arise or in the event of high-risk pregnancies.

Countries with the highest numbers of nurses and midwives per 1,000 people

1. Finland: 22.3
2. Belgium: 20.1
3. Norway: 18.4
4. Switzerland: 18.3
5. Ireland: 18.0
6. Iceland: 16.8
7. United States: 15.7
8. Germany: 14.2
9. Australia: 13.1
10. Luxembourg: 12.2

Countries with the lowest numbers of nurses and midwives per 1,000 people

1. Somalia: 0.1
2. Chad: 0.2
3. Niger: 0.2
4. Central African Republic: 0.3
5. Madagascar: 0.3
6. Equatorial Guinea: 0.3
7. Benin: 0.3
8. Afghanistan: 0.4
9. Angola: 0.4
10. Haiti :0.4

Pregnant women receiving prenatal care

Prenatal care is critical to ensuring a healthy pregnancy. 23 countries indicate that 100% of their pregnant mothers receive prenatal care. Those countries are:

• Finland
• Slovenia
• Sweden
• France
• Germany
• Austria
• Spain
• Ireland
• Portugal
• Lithuania
• Canada
• Turkmenistan
• Armenia
• China
• Malta
• United Arab Emirates
• Fiji
• Kyrgyzstan
• Grenada
• Kuwait
• Dominica
• North Korea
• Bahrain

Many high GDP countries and OECD countries do not release their rates of prenatal care. Countries that do not report their percentage of pregnant women receiving prenatal care are Belgium, Norway, Switzerland, Iceland, Luxembourg, Israel, Japan, Netherlands, Denmark, United Kingdom, South Korea, Croatia, Poland, Hungary, Singapore, Bulgaria, Mauritius, and Greece. We could not find a reason why these countries fail to report this metric.

UNICEF reports that globally only 60% of women are estimated to receive at least four prenatal medical visits. The World Health Organization recommends at least eight prenatal medical appointments for a safe pregnancy. UNICEF also states that areas with the highest maternal mortality also have fewer prenatal care visits.

Countries with the lowest percentages of women receiving prenatal care

1. Somalia: 31%
2. Central African Republic: 52%
3. Chad: 55%
4. Yemen: 60%
5. Afghanistan: 65%
6. Nigeria: 67%
7. Ethiopia: 74%
8. Bangladesh: 75%
9. Papua New Guinea: 76%
10. Vanuatu: 76%

Total births attended by skilled health staff

Having qualified medical care at the birth of a child is an important step in ensuring that both mother and baby are well taken care of. While 59 countries have 100% of their births attended by skilled healthcare staff, many still do not.

Countries with the lowest percentages of births attended by skilled health staff

1. Chad: 24%
2. Ethiopia: 28%
3. Somalia: 32%
4. Eritrea: 34%
5. Niger: 39%
6. Central African Republic: 40%
7. Haiti: 42%
8. Nigeria: 43%
9. Yemen: 45%
10. Guinea-Bissau: 45%

Infant Mortality Rate and Maternal Mortality Rate

While the birthing process can be dangerous, countries that offer the best care before, during, and after childbirth will often have the lowest infant and maternal mortality rates. We collected the rates of both of these unfortunate factors from the CIA’s World Factbook; the numbers of maternal deaths are per 100,000 live births, and infant mortality is per 1,000 live births.

Countries With the Lowest Rates of Infant Mortality per 1,000

1. Slovenia: 1.5
2. Singapore: 1.6
3. Iceland: 1.7
4. Japan: 1.9
5. Finland: 2.2
6. Norway: 2.3
7. Czech Republic: 2.4
8. Sweden: 2.5
9. Portugal: 2.5
10. South Korea: 2.9

Countries With the Highest Rates of Infant Mortality per 1,000

1. Afghanistan: 106.8
2. Somalia: 88.0
3. Central African Republic: 84.2
4. Niger: 68.1
5. Chad: 67.0
6. Sierra Leone: 65.3
7. Gambia: 65.0
8. Equatorial Guinea: 63.3
9. Mozambique: 63.0
10. Democratic Republic of the Congo: 62.6

Countries With the Lowest Maternal Mortality Rates per 100,000

1. Norway: 2
2. Poland: 2
3. Italy: 2
4. Finland: 3
5. Czech Republic: 3
6. Greece: 3
7. Israel: 3
8. United Arab Emirates: 3
9. Iceland: 4
10. Sweden: 4

Countries With the Highest Maternal Mortality Rates per 100,000

1. Chad: 1,140
2. Sierra Leone: 1,120
3. Nigeria: 917
4. Somalia: 829
5. Central African Republic: 829
6. Mauritania: 766
7. Guinea-Bissau: 667
8. Liberia: 661
9. Afghanistan: 638
10. Cote d’Ivoire: 617

Prevalence of Birth Defects

Every year, 8 million children are born with a serious birth defect. Countries with better living conditions, such as healthy food and clean water, were found to have fewer birth defects. See the below section about why the rates of birth defects are much higher in the MENA region.

Countries With the Lowest Prevalence of Birth Defects per 1,000 Live Births

1. France: 39.7
2. Austria: 41.6
3. Australia: 41.7
4. Switzerland: 42.5
5. Italy: 43.2
6. Spain: 43.4
7. Finland: 43.8
8. Germany: 43.8
9. United Kingdom: 43.8
10. Belgium: 44.6

Countries With the Highest Prevalence of Birth Defects per 1,000 Live Births

1. Sudan: 82.0
2. Saudi Arabia: 81.3
3. Benin: 77.9
4. Burkina Faso: 77.0
5. United Arab Emirates: 75.9
6. Tajikistan: 75.2
7. Iraq: 75.2
8. Kuwait: 74.9
9. Afghanistan: 74.9
10. Oman: 74.8

Weeks of Maternity Leave

When comparing the number of weeks of maternity leave offered to new mothers, the United States, Suriname, and Papua New Guinea were at the bottom of the list, offering zero weeks of maternity leave, The United States is the only nation on the list of the world’s richest countries to not offer any federally-mandated maternity leave.

Countries with Highest Rates of Maternity Leave in Full-Paid Week Equivalent

1. Bulgaria: 52.2
2. Macedonia: 39
3. Albania: 32.3
4. Croatia: 30
5. Greece: 26.6
6. Bosnia and Herzegovina: 26
7. Venezuela: 26
8. India: 26
9. Pakistan: 25.7
10. Slovak Republic: 25.5

Countries with Lowest Rates of Maternity Leave in Full-Paid Week Equivalent

Nine countries do not report mandatory maternity leave (Palau, Tonga, Democratic People’s Republic of Korea, Tuvalu, Maldives, Samoa, Bhutan, Micronesia, and Liberia). Below are the lowest rates of maternity leave for countries that report a mandatory minimum.

1. Papua New Guinea: 0
2. Suiname: 0
3. United States: 0
4. Tunisia: 2.7
5. Solomon Islands: 3
6. Paraguay: 4.5
7. Syria: 5
8. Saudi Arabia: 5
9. Nigeria: 6
10. Haiti: 6

Countries with the best access to safe and legal abortion

Each country approaches the topic of access to abortion differently. Many countries have full access to abortion services before a specific gestational period, often 12 weeks but sometimes more or less (“On request”). Other countries only allow abortions if the mother’s life or health is at risk. Others have access to abortion but only under limited circumstances and with a variety of conditions met (“Limited”).

Countries with the least restricted access to safe and legal abortion

1. Singapore – On request until up to 24 weeks
2. Colombia – On request until up to 24 weeks
3. Iceland – On request until up to 22 weeks
4. Netherlands – Gestational limits vary – approximately 22 weeks
5. New Zealand – On request until up to 20 weeks
6. Sweden – On request until up to 18 weeks
7. Maldives – On request until up to 17 weeks
8. France – On request until up to 16 weeks
9. South Korea – On request up to 14 weeks or up to 24 weeks for specified reasons
10. Vietnam – Gestation limits vary – typically up to 18 weeks

Special mention goes to Canada, which only received a B+ on our index but does have regions where women can obtain an abortion on request for up to 23 weeks and 6 days. However, because of regional restrictions, gestational limit variations, and unequal access to services, Canada lost some points in our rankings.

Countries with the most restricted access to safe and legal abortion

There are 19 countries where abortion is altogether prohibited: Haiti, Laos, Madagascar, Mauritania, Senegal, Sierra Leone, Iraq, Republic of the Congo, Suriname, Honduras, Egypt, Nicaragua, Tonga, Dominican Republic, Jamaica, El Salvador, Philippines, Palau, and Malta. The United States recently joined the list of federally unprotected abortions on a country-wide scale when Roe v. Wade was overturned on June 24, 2022, but with the caveat that some states will allow it.

• Nursing and midwifery personnel (per 10,000 population)
• Nurses and midwives (per 1,000 people)
• The State of the World’s Children 2021 Statistical Tables
• Pregnant women receiving prenatal care (%)
• Births attended by skilled health personnel (%)
• Births attended by skilled health staff (% of total)
• CIA – Infant mortality rate
• CIA – Maternal mortality rate
• March of Dimes Global report on birth defects
• Length of maternity leave
• Parental leave systems
• The State of World’s Midwifery 2021
• The Women’s Abortion Laws map