Why We’re Running in Iceland: The History of Maternal Health in Iceland

Many of our conversations about maternal health revolve around negative outcomes, challenges and barriers that too many women face.

It’s easy to forget that plenty of countries and healthcare providers are doing things right. That’s why a dozen Team EMC runners are participating in the Íslandsbanki Reykjavík Marathon on Saturday, August 20th. We think Iceland has a lot to teach us.

Iceland is home to 326,000 people and fewer than five thousand babies are born there every year. For decades, they’ve consistently had some of the best maternal health outcomes in the world.

Icelandic women can deliver anywhere — at home, birth center or hospital. Their midwife-run maternal health system supports women’s choices and normal physiologic birth. The offer full spectrum care, including pain management options, but avoid unnecessary interventions like continuous fetal monitoring and Pitocin — a synthetic version of the hormone oxytocin, which causes contractions and is commonly used in the U.S. and other countries to induce, strengthen or accelerate labor.

Iceland has also ranked #1 In the World Economic Forum’s Global Gender Gap Report every year since 2009. Women are well represented in politics and the workplace and healthcare aren’t political issues. They have universal healthcare, generous pre and postnatal care programs, midwifery-run maternity units and integrated options for home deliveries. Obstetricians handle complications, but overall, midwives run the show and their outcomes are excellent.

In the 25-year period from 1989 to 2009, 107,871 deliveries occurred. There were only five direct maternal deaths (from sepsis, severe preeclampsia, and choriocarcinoma) and five indirect maternal deaths (from pre-existing cardiac and diabetic illnesses). Nobody died from postpartum hemorrhage, ectopic pregnancy or anesthesia complications, which are leading contributors to maternal deaths in the U.S. and other countries with high C-section rates.

Iceland has been strong on women’s rights since the mid-19th century, but Icelanders say that on October 24, 1975 women’s status in society took a big step forward. That’s when 90 percent of Icelandic women walked off the job and out of their homes to demonstrate for equal rights. They brought the nation to a standstill then rapidly accelerated public policy to better represent women. Within months, progressive reproductive, maternal health and maternity leave laws were passed. Five years later, they elected a divorced, single mother as president of Iceland, making her the first woman in the world to be democratically elected as a head of state.

Now that you have the history, check out our interview here with Olöf Ásta Ólafsdóttir, Director of Midwifery Studies at the University of Iceland.