I. Maternal & Infant Mortality
Commonwealth Fund International Comparison (2024)
The most expensive healthcare system produces the worst outcomes for mothers
Cross-country analysis of maternal and infant outcomes among high-income nations. The US spends the most and ranks last. Maternal mortality is 4-7x higher than Scandinavian countries.
The Commonwealth Fund is a private healthcare foundation that publishes cross-country health system comparisons. Their 2024 maternal health report ranked the United States last among high-income nations. American mothers die at four to seven times the rate of mothers in Norway, Sweden, the Netherlands, and Japan.
The US spends about 17 percent of GDP on healthcare, the highest in the world, and runs maternal mortality numbers that look closer to countries spending three to four percent. The report breaks deaths down by when they happen. Most US maternal deaths happen postpartum, often weeks after the hospital discharge.
The countries that do better tend to share a few things: universal midwifery, longer postpartum follow-up, and no financial incentive to push mothers out of the hospital fast. The report does not argue for any one policy fix. It just lays out the pattern.
Last
US ranking among high-income nations
17%
US healthcare spending as share of GDP
4-7x
Maternal mortality gap with Scandinavia
~6 wks
Where most US deaths happen postpartum
Why it matters
Money is not the missing variable. The countries beating the US spend far less and lose far fewer mothers, which makes the system itself the question, not the funding.
This is one finding from the research library behind How to Birth a Mother. Everything here traces back to a study, a dataset, or a systematic review.