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A baby born in the developing world must fight to survive right from the start, with up to two million deaths occurring in the first 24 hours of life every year, according to a global report on mother and infant mortality.
Many of those deaths could easily be prevented with cheap interventions, such as knit caps to keep newborns warm or clean blades to cut umbilical cords, according to the analysis released Tuesday by the US-based group, Save the Children.
Expectant mothers also do not fare well in poor countries, with half a million women dying annually from complications during pregnancy or birth often because they have no care before, during or after their babies are born, the report said. A huge number of women give birth at home alone or with no skilled attendant.
"In most of the developing world, childbirth is a dance with death for both mother and baby, even though 70 percent of those deaths could be prevented," said co-author Anne Tinker, director of the organization's Saving Newborn Lives Initiative. "The secret is really knowledge."
The 50-page report released ahead of Mother's Day compiles data from the world's nations as well as the World Health Organization and UNICEF. It presents a bleak look at the challenges pregnant women and newborns face in impoverished countries, where up to 99 percent of deaths occur - illustrating the wide gap between rich and poor nations.
For instance, one in every five women in sub-Saharan Africa has lost a newborn, along with one in every seven women in South Asia. Some four million babies die in their first month of life each year - the total number born annually in the United States.
The report highlights the need for better education and nutrition among expectant mothers, along with the importance of breast-feeding. It offers cost-effective options, including tetanus shots, which cost about 40 cents, to protect moms and babies against infection, especially from dirty instruments that may be used during birth.
The study found that most newborn deaths result from some type of infection, such as pneumonia or diarrhea, or complications related to premature births. Low birth weight and lack of good care also contribute.
Cultural or traditional practices also can be problematic in some countries where rituals, such as using cow dung on umbilical cords or immediately bathing newborns and letting them dry in the cold, can lead to higher mortality.
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