Editor’s Note: Anna wrote this post (and several others) before she left on maternity leave. She gave birth to a healthy baby girl in December.

Baby in StrollerWhen Fit Pregnancy Magazine set out to rank the best cities in America to have a baby, they found that Northwest cities did surprisingly well: they ranked Portland number one, while Seattle landed the number four spot. (Minneapolis came in second, San Fran third.)

So why did Portland take the cake? The Oregon metropolis does well on healthy food, walkable neighborhoods, lots of birth options, and solid breastfeeding numbers.

Here’s the rundown:

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  • To compile its rankings, Fit Pregnancy collected data on 47 topics, for the 50 largest US cities, using the most recent information available from government agencies, private foundations, professional associations, and public databases. Here’s what put Portland on top:

    • Relative to population, Portland has more specialty retailers of healthy/organic foods and vitamins than most places.
    • Portland has 150 miles of stroller-friendly trails and public pathways, according to a survey of parks departments. In a per capita comparison, that’s 163 percent more than the average city surveyed (3rd highest overall relative to population).
    • 14.9 percent of births statewide are attended by midwives. That’s 98 percent more than average. Midwifery is more widely available in Portland than anywhere else surveyed, with 189 percent more midwives than average. Relative to the number of live births per year, Portland has 64 percent more doulas than average—that figure is the 5th highest in the survey.
    • 25 percent of babies in Oregon are born via Cesarean section. That rate is 8 percent less than average, and among the lowest in the survey.
    • 26.6 percent of Portland mothers breastfeed their babies exclusively (meaning no solids, formula, or other liquids) for six months or longer (as recommended by the American Academy of Pediatrics.) That’s among the top 2 percent of cities in the survey. Eighty-nine percent of Portland mothers attempt breastfeeding. That’s the highest percentage of any city in the report. Portland moms are 20 percent more likely than average to at least try breastfeeding. Compared to the number of babies born, Portland has 81 percent more lactation consultants than average. That’s the 2nd highest ratio Fit Pregnancy found. And, once Portland mothers begin breastfeeding, they are 19 percent more likely than average to continue through 6 months. That’s the 3rd highest level of follow-through of any city studied. Finally, By six months of age, 42 percent of Portland babies are still being breastfed. That’s the highest percentage of any city in the report.
    • According to data from the CDC, maternal mortality in Oregon is especially low.
    • Portland babies are 22 percent less likely than average to be born prematurely.
    • Oregon allows greater dependent-related tax breaks than most.
    • Portland babies are 25 percent less likely than average to be born with low birth weight.
    • Portland has 22 licensed home day cares for every 1,000 children under 4 years, the 9th highest in the survey. State laws require stringent background checks for day-care workers
    • Portland has plenty of high-risk pediatricians, 78 percent more than average and the 10th highest in the survey.

    Where could Portland use improvement?

    • State laws do not require health insurance companies to provide or offer any fertility-related services.
    • Portland lacks access to fertility clinics that offer advanced reproductive technology, as reported to the CDC.
    • There are just four licensed day care centers for every 1,000 children under four years. That’s 41 percent less than average.
    • Portland has a 26 percent higher property crime rate than average, the 7th highest in the survey.

    Let’s look at Seattle too, while we’re at it.   While Seattle shares many of the “pros” that Portland boasts, it also has some blemishes on its report card:

    • At $100, the average doctor’s office visit here is the 7th highest in the survey, compared to a national average of $82.
    • Air quality here is worse here than most cities in the survey. Air quality has been linked to childhood asthma and fertility rates, among other things.
    • State laws do not require health insurance companies to provide or offer any fertility-related services.
    • Seattle has 1.8 NICU facilities per 10,000 births, 9th lowest in the survey. The average city surveyed has 3.4 NICU facilities per 10,000 live births.
    • Seattle has a 21 percent higher property crime rate than average, the 9th highest in the survey.

    This covers the Northwest’s big cities.  But our smaller communities? What kinds of choices do families in Spokane or Bend have when they want to have a baby? (Leave a comment and let us know how your town measures up.)

    And of course, having a baby is only the first step. I’d like to hear how Northwest cities rank when it comes to livability for families in general. Is housing affordable in safe, family-friendly, walkable neighborhoods? How do we rate on early childhood education—or all levels of schools for that matter? Is healthy, organic food affordable and accessible?

    Where’s the best place to grow up?