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Save the Children lists 10 countries where motherhood is a daily, life-or-death struggle.

This week, Save the Children released its annual report on the State of the World's Mothers, which ranks the status of mothers in countries worldwide using a wide set of criteria including female life expectancy, lifetime risk of maternal death, women's economic equality, child mortality, and working conditions for mothers.

Topping this year's index is Norway, the developed country with one of the highest ratio of female-to-male earned income, the world's highest contraception rate, and one of the most generous maternity leave policies anywhere. Northern Europe dominated the top 10 with the United States coming in at a not particularly impressive 31st, thanks in part to its 1 in 2,100 maternal death ratio -- the highest of any industrialized nation-- and its maternity leave policies, the shortest and least well-supported financially of any wealthy nation.

This Mother's Day, it's worth remembering the struggling moms in the following 10 countries, who make up the bottom of the list.
 Spencer Platt/Getty Images 

AFGHANISTAN
In the world's hardest country to be a mother, a typical woman has fewer than five years of schooling and is only expected to live to 45. Fewer than 16 percent of women use modern contraception, and one child in five dies before reaching age 5. At that rate, every mother in Afghanistan is likely to suffer the loss of at least one child.

Measures to improve women's health and safety during the NATO-led occupation have often come under attack from religious extremists. In one well-publicized instance, the government had to take control of the country's women's shelters after a popular broadcaster suggested they were fronts for prostitution.

Afghanistan's strictly enforced gender separation combined with the  lack of midwives and female doctors in the country also frequently prevents mothers from getting the medical care they need.
NICOLAS ASFOURI/AFP/Getty Images 



NIGER
A typical woman receives fewer than four years of education in Niger. Only a third of births are attended by a skilled health professional, resulting in one of the world's highest infant mortality rates.

With the assistance of UNICEF, the country recently began offering free prenatal care like insecticide-treated bed nets, medicine to prevent malaria and tetanus, as well as vitamins. With the average woman in Niger giving birth to seven children and most living far from a health center, help can't come too soon.
MUSTAFA OZER/AFP/Getty Images

GUINEA-BISSAU
Only two girls for every three boys are enrolled in school in Guinea-Bissau, one of the lowest rates in the world. Women, on average, can expect fewer than five years of education, and only 6 percent of women have access to modern contraception.

It's not uncommon for women to be married as young as 13 or 14, and the World Bank estimates that nearly one-third of homes are polygamous.  Pregnant women in Guinea-Bissau often work right up until the time they begin feeling labor pains.
SEYLLOU/AFP/Getty Images

Maria Susana Diaz

I like nature, cooking and photography. In my travels between Argentina and Italy I prefer witness through photography environment, natural and gastronomic riches.

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