Women in America are wondering what it would be like to lose access to safe and legal abortions after a Supreme Court draft opinion threatening to overturn Roe v. Wade leaked Monday.
The health care outlook is bleak. Restrictions on abortions can have devastating impacts: Experts have long pointed to research that shows both women and children’s health outcomes worsen on a variety of measures when abortions are banned or restricted.
Compared to other wealthy nations, the United States is already far behind. The U.S. ranks poorly in terms of health care, with some of the highest rates of infant mortality, maternal mortality and medical costs among the developed nations, according to an NBC analysis.
The U.S. is also the only high-income country that offers zero weeks of paid maternity leave. While some workers in America have access to paid leave through their employers, there is no national law that mandates it. In Europe and elsewhere, subsidized parental leave is standard, with nations like Norway offering new parents up to 86 weeks.
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To evaluate the U.S, we compared it to 10 other high-income nations, in line with analysis from the Peterson Center on Healthcare and Kaiser Family Foundation, which define comparable countries as OECD nations — democratic countries that support free-market economies — with both above median GDP and GDP per capita in at least one of the past 10 years.
Those benchmark countries are: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom.
U.S. & World
The United States is the only developed nation in the world with an increasing maternal mortality rate.
In 2019, the national rate went up, measuring 20.1 deaths per 100,000 live births, a ratio that is far greater than other high-income countries. To date, it’s almost doubled from 10.3 in 1991. The overall maternal mortality rate also masks stark disparities by race and ethnicity. Black women face three times the maternal mortality risk as white women.
Infant mortality, which is a widely-reported indicator of population health, is also higher in the U.S. than comparable nations.
In 2020, 5.4 infants died per 1,000 live births in the United States. The next highest country was Canada at 4.4, while the lowest, Norway, only reported 1.8. Similar to maternal mortality, there are significant racial disparities for infant mortality rates. Black mothers experience the highest infant mortality rate among all groups, reporting over twice the average at 10.97 deaths per 1,000 live births.
Paid Maternity and Paternity Leave
The United States is the only wealthy nation without a federal paid family leave policy.
The average length of paid maternity leave among OECD nations is 18.4 weeks, with many of the world’s largest economies also guaranteeing paid paternity leave. In comparison, Estonia offers more than a year and a half of paid leave to new parents.
While the U.S. does not have a national paid leave mandate, California, New Jersey, New York, Rhode Island, Washington and the District of Columbia all have state-mandated paid leave plans in place. Some private employers, however, also offer paid leave to either parent after the birth or adoption of a baby.
Child Care Costs
After giving birth, Americans will also spend more on raising children.
A single parent with two kids making an average wage and receiving no housing or social assistance would need to budget about 38% of their net household income for full-time day care, according to OECD data for 2019.
Compared to similar countries, the U.S. is an outlier for its lack of financial support for young children. The government spends just 0.2 percent of its GDP on child care for children 2 and under, which works out to about $500 per child. Sweden, alternatively, spends around $18,000 per child.
Despite worse maternal and infant mortality rates, Americans are spending thousands more than citizens of other countries on healthcare expenses. America’s for-profit health insurance system, one of the only ones in the world, is the leading cause for the country’s high costs.
Americans spent roughly $12,000 on healthcare per person in 2020, over $4,000 more than the next highest country, according to data from the National Health Expenditure.
Other countries with comparable GDP report healthcare expenses to be around half of what the average American can expect to pay.
It’s clear from the numbers that the U.S. is already well behind its peers when it comes to health care measures and financial support for parents. Abortion bans further harm vulnerable groups.
U.S. states with some of the nation’s strictest abortion laws are also some of the hardest places to have and raise a healthy child, especially for the poor, according to an analysis of federal data by The Associated Press.
That reality raises questions about the strength of the social safety net, especially as those states are poised to further restrict or even ban abortion access should the Supreme Court overturn Roe v. Wade. A final decision is expected in June.