Pregnant women living in poor urban areas frequently lack access to health care, despite cities offering better clinics and highly-skilled doctors than rural areas, the United Nations children agency (UNICEF) says in a report. The aid agency’s flagship State of the World’s Children report – which this year focuses on urban poverty – warned that the basic needs of children are not being met amid the world’s rapid urbanization. Most deaths from pregnancy or childbirth could be averted if expectant mothers could be assisted by skilled professionals with proper medical equipment, the agency said. But the health care available to poor urban dwellers is of much lower quality than that available to wealthier residents, and skilled obstetricians are in shorter supply. The poorest are often forced to resort to backstreet clinics or pay for decent health care. In 2008, more than 350,000 women worldwide died during pregnancy or while giving birth, and many more suffered from injuries such as obstetric fistula, the report said. BREASTFEEDING Urban mothers are also less likely to breastfeed, according to the UNICEF report. Breastfeeding in the first six months of a child’s life is considered crucial for meeting a newborn’s nutritional needs, and can reduce infant mortality by some 20 percent in certain regions. An analysis of Demographic and Health Survey (DHS) data from 35 countries cited in the report found that the percentage of children who were breastfed was lower in urban than rural areas. URBAN DANGERS Mother comforts her baby. Image: Yogendra Joshi For women and girls living in poor urban settlements sexual harassment and violence are a daily risk, the report added. The dangers may increase if they have to walk through dodgy neighborhoods or travel on unsafe routes to get to work or school. Despite these well-known risks, local administrations frequently overlook specific threats to their girls and women in urban planning. A global initiative by the United Nations women agency (U.N. Women) is working closely with five cities around the world to find the best comprehensive approaches to prevent and reduce violence against women and girls in public spaces. For example, the Safe Spaces program in Kenya is helping young girls growing up in slums by providing spaces for recreation, opportunities for mentoring and a forum for discussion.