Macedonia

The landlocked country of Macedonia was a part of Yugoslavia until it gained independence in 1991 (recognized 1993), and has a population of 2.1 million. It has a birth rate of 12 per 1,000, and an infant mortality rate of 9.8 per 1,000 live births. The latter figure has been greatly reduced in recent years following an improvement in the health care system—prior to that, the rate was 15 per 1,000 live births for infants, and 17 per 1,000 for children under the age of 5. Although these figures are good by regional standards, the Roma (gypsy) population have much higher mortality rates than the general population.

Abortion is available upon request during the first 10 weeks of pregnancy in Macedonia; after that time, a medical commission must approve the request. Abortions must be performed in a medical facility and parental approval is required for minors. In 2001 the abortion rate for women 15–44 years of age was 18.4 per 1,000. Divorce does not require a finding of fault, and in 2009 there were 1,209 divorces, as opposed to 14,695 marriages (in a population of approximately 2 million). In 2000, maternal mortality for women aged 15–49 was 23 per 100,000, and in 2000–05, infant mortality was 15.4 per 1,000 live births for females and 17.5 per 1,000 for males. Six percent of children were of low birthweight. Almost all births (99 percent in 2004) are attended by skilled medical personnel.

Traditionally, the women in Macedonia were restricted to remaining in villages, where they were involved in bringing up children, minding the family home, preparing food, and looking after vegetable gardens. Few were able to combine motherhood with careers, although often adversity forced this upon them. For example, when Nikollë Bojaxhiu, an Albanian building contractor in Üsküb (now Skopje, capital of Macedonia) died in 1919, it forced his widow, Drana, to establish a home-based business selling cloth and hand embroidery. Her youngest child, Agnesë, would become famous many years later as Mother Teresa of Calcutta, the recipient of the 1979 Nobel Peace prize.

A part of the kingdom of Yugoslavia until World War II, there was little in the way of organized medical care for pregnant women or for childcare, but a tradition of living with or near extended families helped during difficult circumstances.

Beginning in the 1950s, there were considerable attempts by the Communist Yugoslav government to improve health care, and this resulted in dramatically reduced infant and maternal mortality rates. These were improved further after the breakup [Page 674]of Yugoslavia and Macedonia, which avoided the destruction of much of former Yugoslavia in the fighting during the 1990s.

As well having as hospitals in all major cities, there are 1,200 clinics in suburbs, towns, and villages to assist with midwifery and general health care. Improved education levels has also contributed to the reduction in the fertility rate, from 2.7 in 1975 to 1.8 in 1999. The percentage of extramarital births rose from 6.6 percent to 9.8 percent, yet still remained one of the lowest in Europe.

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