-- The newborn death rate in the United States is higher than in 40 other countries including Malaysia, Cuba and Poland, according to a new study. The study, published in the journal PLoS Medicine, examines data from 190 countries, finding that newborn deaths have declined over the past 20 years from 4.6 million in 1999 to 3.3 million in 2009.
But despite the overall decline, infant mortality has dropped much more slowly than other age groups, accounting for 41 percent of child deaths worldwide.
While the infant mortality rate in the U.S. is high compared with other wealthy countries, 99 percent of infant mortality occurs in low-income countries. Just five -- India, Nigeria, Pakistan, China and the Democratic Republic of Congo -- account for more than half of the 3.3 million annual newborn deaths. India alone has more than 900,000 a year.
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Joy Lawn, one study author, believes this is because there is no strong leadership to make newborn health and survival a priority. "We haven't had the right people shouting for it," Lawn told ABC News. Unlike the HIV movement, which has had voices from rich and poor nations and all walks of life, newborn mortality has garnered very little attention, despite the staggering numbers.
Lawn knows the global challenges for newborns very personally. Her mother suffered from an obstructed labor when she was born in Northern Uganda more than four decades ago. According to Lawn, she probably would not have survived if it hadn't been for the midwife who noticed she was in the wrong position and got her mother to a hospital for a cesarean section.
Simple Solutions Exist
According to Lawn, the great tragedy is that at least a third of these deaths could be prevented with extremely cheap and simple solutions- breastfeeding, for instance, making sure that women don't give birth on a dirty surface, keeping babies warm after birth.
But these interventions are not high on the global health agenda. "Most of the big organizations that fund global health initiatives still barely mention newborn deaths," Lawn told ABC News.
There have been some success stories that prove the possibility. In northern India, a recent study found that using simple interventions like making sure mom and baby were in a clean environment and that the baby was kept warm after birth reduced newborn mortality by more than 50 percent. "You can get rapid change, you can change things within two years," said Lawn. "You just need the will."
Coping With Silent Deaths
Even in the U.S., newborn mortality is not often talked about. But a digital movement is helping parents deal with the death of a child.
Los Angeles mom Heather Spohr gets e-mails every day from strangers around the world about her popular blog, The Spohrs are Multiplying, which receives more than one million views a month. Part of her internet success is the result of an effort to cope with her family's toughest moment -- the premature birth and subsequent loss of her firstborn daughter, Madeleine.
Spohr first started blogging over ten years ago, but when she was placed on bed rest for a complicated pregnancy, her Web tales took on a new life. The blog's popularity grew with her pregnancy, but the tipping point was perhaps when Madeleine passed away. She started receiving e-mails from strangers who had experienced similar tragedy.
"Grieving is so personal, everyone does it differently. It's not linear." Blogging, Spohr told ABC news, is "really convenient. You can come and go and get the support when you need it, as opposed to going at a certain time every day," as with counseling.
Many of the most popular mom bloggers (who regularly receive millions of visits to their respective websites) became famous after struggling through a stillbirth or the loss of a child, according to several people in the community. They say the Web is a place where they can talk candidly about these difficult issues that are so rarely discussed in public.