The chance of a woman in the Netherlands dying during pregnancy or childbirth has decreased by over half since the start of the century, making the Netherlands the fifth-safest country in the world to have a baby.

Where at the end of the 20th century, one woman in 4.400 would die during pregnancy or in childbirth, now that chance has dropped to one in 10.500.

This is according to the State of the World’s Mothers, a report by charity Save the Children, a leading independent organisation that works to create lasting change for children in need around the world.

The Netherlands is the only country in the index’s top 10 that has seen such extraordinary improvement since the report began in 2000, moving up several places in the report's index over the last few years.

Increase in western maternal mortality

In a stark contrast to the Netherlands, other western countries have seen their figures increase by half, including the United States and Denmark. While Denmark is still in the top 10, the United States is ranked at 31, behind most European nations.

Other western countries showing deteriorations include Switzerland (by 19 per cent), Spain (by 23 per cent) and New Zealand (by 27 per cent).

While there is currently no explanation for these increases in risk, Save the Children say many suspect that it is due to a greater number of higher risk pregnancies from obesity, diabetes and cardiovascular disease, among others, all of which are growing more common.

World's most vulnerable mothers

The 2014 report specifically focuses on women and children living in fragile communities beset by conflict and natural disasters. More than 60 million women and children are in need of humanitarian assistance this year, while every day, 800 mothers and 18.000 young children die from largely preventable causes.

 "Over half of these maternal and under-five deaths take place in fragile settings, which are at high risk of conflict and are particularly vulnerable to the effects of natural disasters," the report says.

This explains the countries on the bottom of the list. Many of them are in Africa, while the last is Somalia, where one in sixteen mothers do not survive pregnancy. Others include the Democratic Repulic of Congo, Niger and Mali.

Most current and previous bottom 10 countries are among the poorest in the world and have either been enduring or emerging from a humanitarian crisis since the start of the State of the World’s Mothers’ index. Two-thirds of these countries have suffered persistent natural disasters in that time, while only four have not been involved in armed conflicts.

How to improve maternal survival

Save the Children believes that in order to improve the situation in the most vulnerable countries, more should be done to end and prevent conflicts, reduce vulnerability to natural disasters and provide refugees and displaced persons with health care, food and education.

In the end, the report concludes that "ending preventable deaths of mothers and children will not be possible until such countries become more stable and health care more accessible."

Top 10 countries for mothers

1.	Finland
2.	Norway
3.	Sweden
4.	Iceland
5.	Netherlands
6.	Denmark
7.	Spain
8.	Germany
9.	Australia
10.	Belgium

For more information, read the report.

Sources: Save the Children, NRC