The baby girl cooing in a hospital in the Pakistani capital was long awaited. Her mother, Ambreen Saddam, 28, had been trying to conceive for four years. She gave birth at 9 a.m., Islamabad time, Jan. 1, 2020. That date made the birth even sweeter, says Saddam.

"It's a very happy time for us," she says, lying beside her tiny, five-pound baby, who was wrapped in a bright pink blanket in a crammed maternity ward at a sprawling health compound in the city.

In some ways, the world is also celebrating with her.

UNICEF, the United Nations children's agency, estimates that some 400,000 babies will be born on New Year's Day — "an auspicious day for childbirth around the world," it said in a press release.

UNICEF says the Pacific island nation of Fiji will most likely have delivered 2020's first baby – and it's expected to have 39 births on Jan. 1. The United States will deliver the last baby of New Year's Day, where women are expected to welcome 10,452 babies into the world.

The births also offer a quick snapshot of global demographic trends.

UNICEF says over half those births will happen in just eight countries: India, with 67,385 expected births, followed by China, Nigeria, Pakistan, Indonesia, the United States, the Democratic Republic of Congo and Ethiopia, with 8,493 expected births.

Those babies add to the world's current population of about 7.7 billion – a population that the U.N. expects to peak at nearly 11 billion in 2100. Much of that growth will happen in nine countries and four of them are in Africa – Egypt, Tanzania, Nigeria and the Democratic Republic of Congo.

UNICEF says it is calling attention to newborns – babies under one month old – because it's such a risky time. It estimates that in 2018, newborns accounted for 47% of all deaths of children under five years old, despite what UNICEF says is "remarkable progress in child survival" over the decades.

In Pakistan, that translates into 700 babies dying a day, says Samia Rizwan, a health specialist at UNICEF. "Newborn mortality, especially in some countries, has been very high, and Pakistan is one of them."

What concerns her, she says, is that "newborns are dying because of preventable causes, which are birth asphyxia, prematurity and sepsis."

Rizwan says these babies can survive their first perilous days – and live into the decades beyond – if more investment is put into getting women to give birth in institutions where they can have skilled health attendants and get appropriate medications.

Despite well-intentioned efforts by the Pakistani government, she says nearly one-third of women in the country don't have access to a skilled birth attendant – a nurse, a midwife or doctor.

Even women who do get a skilled attendant often don't get their full attention, because "they are overburdened," says Rizwan. And those attendants can't always follow up after birth.

Rizwan says that's largely because Pakistan's high birthrate means public health services are constantly overwhelmed. "We are facing a challenge of rising population," she says.

At least for now, Ambreen Saddam might just stick to her one little girl, who doesn't have a name. She winces when we ask if she'll have another. "Not for now," she says, laughing.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

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