The Power of First Moments


Photo: Michael Tsegaye/Save the Children

This blog was adapted from Carolyn Miles’ presentation at the 2013 AWHONN Conference in Nashville, TN. 

Every parent knows the magic of that moment.  That moment when you meet your child face-to-face for the first time, when you hold your baby in your arms and realize—this brief and precious moment has changed my world forever.

Many different moments have changed my life—but the three I’m proudest of are when I first met Keegan, Patrick and Molly.

At Save the Children, we focus on all the little moments during childhood that can lead to a fulfilling future.  We work to ensure all children get a chance to learn, that they’re protected from harm, that they have enough food to eat—but to make all of that possible, we have to start at the very beginning. 

So while my first moment with each of my children was very different—ranging from a state-of-the-art delivery room to a small orphanage in Vietnam—I had something in common with every other mother: an overwhelming sense of love and a fierce determination to keep my child safe.

The instincts of motherhood are felt equally across the globe—but unfortunately, the circumstances are not.

Save the Children’s fourteenth annual State of the World’s Mothers report tells us the best and the toughest places to be a mother in the world today—taking into account 5 key indicators in a mom’s life:  maternal and child health, maternal and child health, and women’s educational opportunity, economic status and political representation.

Our 90 years of experience have shown us what all mothers know to be true—that an empowered mom is the best champion for her child’s future and that the quality of children’s lives is directly related to the health, security and well-being of their mothers.

This year, Finland tops our Mothers’ Index of 176 countries, while Democratic Republic of the Congo—where one in 30 women will die from pregnancy-related causes—occupies the bottom spot. When it comes to being a mom, these countries might be on the same planet—but they’re in completely different worlds.

And this isn’t just a developing world problem.  The United States ranks 30th, in part because our child mortality rates are higher than in comparable nations. Shockingly, more than 11,000 American moms lose their newborn on the first day of life every year—the highest rate of first-day death in the industrialized world. Worldwide, 1 million babies die the day they are born.

I just returned from a trip to India where I met several mothers and babies, including this one-hour old little girl, who was already blinking up at me curiously as her mother recovered in her hospital bed nearby.  For me, the joy on her mom’s face was a welcome sight after days of meeting with mothers who weren’t so lucky.  Their stories of heartbreak are far too common.  Our report shows that India leads the world in the number of first-day deaths, losing 300,000 of their newborns every year. 

This year’s State of the Worlds Mothers report focuses on the first day of a child’s life—and how we can turn this dangerous day for newborns into what all parents hope for: the first moment in a life full of potential.

Since 1990, the world has reduced maternal and child deaths at an astonishing rate, but we’ve made slower progress in reducing newborn death. Child deaths have been cut almost in half—but newborn mortality has dropped at a much slower rate, so it now accounts for 43% of all under-5 child deaths…and way too many of these occur in the very first day of life.

The most common causes of newborn death are prematurity, severe infections and birth complications—but the good news is that the majority of these are preventable with proven, low-cost interventions.

Even in low-income countries with poor infrastructure and difficult access to health care, trained frontline health workers are showing how simple solutions can make a huge difference in those precious first minutes and hours.

Four easy interventions—none of which require millions of dollars or elaborate technologies or top-tier health facilities – leverage a few basic tools and a little know-how to give babies the best chance, no matter where they are.

  • First, clean cord care. 25% percent of newborn deaths are caused by infections. By cutting the umbilical cord with a new, clean razor and treating it with a low-cost anti-septic, anyone can protect a baby from a life-threatening infection.
  • In Nepal, where 63% of births take place at home, anti-septic ointment is being promoted nationwide by health workers who deliver babies.  They use the Nepali word “kawach,” meaning “shield”—a fittingly heroic word for this tiny tube of medicine. 
  • Second, life-saving antibiotics.  Sepsis is an infection that affects a baby’s entire body, but an injection of antibiotics costing less than $2 could save more than half a million newborn lives every year if available to every baby who needed it.
  • In Ethiopia, a health worker paying a routine home visit noticed two-day-old Natnael was feverish and restless and was having trouble breathing.  A course of injected antibiotics started working immediately and now his happy mother tells other mothers in her community how to seek treatment.
  • Third, promoting lung growth.  Preterm babies often struggle with underdeveloped lungs. But if a mother is in preterm labor, an injection of steroids can stimulate lung development and prevent babies going into respiratory distress when they’re born—all for a little more than 50 cents.
  • In Uganda, 14 of every 100 babies are born preterm. The government of Uganda has pledged to do more for preemies, and will soon provide steroid injections for all women in preterm labor.
  • And last, helping babies breathe.  Babies are frequently born not breathing, and early action is crucial.  Drying and gently rubbing the baby will often stimulate breathing, or a basic resuscitation device consisting of a bag and a mask can make all the difference—to the tune of 229,000 newborn lives a year.
  • In Indonesia, a difficult birth meant that baby Naisa was wrapped in her umbilical cord.  When she was born, she was slightly blue and she didn’t cry.  But the birth attendant cleared her airway and resuscitated the baby with a tube, leading to the moment her mother had been waiting for: a healthy, loud, high-pitched scream.

These proven interventions – coupled with stronger health systems and sufficient health care workers who are trained, deployed and supported to tackle the key causes of child mortality – have the potential to reduce newborn deaths by as much as 75 percent. This would save more than 2 million newborn lives each year.

There was another moment in my life that stands out for me. I was living in Asia and traveling to the Philippines with my two young sons.  I had Patrick, just six months old, sitting on my lap as we made our way from the airport on streets lined with slums.

At a stoplight, I locked eyes through the car window with a mother begging by the side of the road, holding a child about the same age as Patrick.  The child in my arms was no smarter, or cuter, or better than hers—but my son would have so many more opportunities, simply because of where he was born. The unfairness of it all hit me hard. And before I knew it, in the moment before the light turned green, my life had changed again.


(L to R) Carolyn Jones, Photographer and Filmmaker, American Nurse Project
Mimi Pomerleau, President, AWHONN
Carolyn Miles, President and CEO, Save the Children

I began a new career that brought me to Save the Children—to speak out for what every mother wants:  that each baby gets the best possible chance at life and a fulfilling future.

So this is our global call to action – and I’ve been saying this at the United Nations, at events and to moms around the world. I hope you remember the important first moments in your life and they help you raise your voice to help create real and lasting change for children.


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