05/22/2014 12:00 am ET

10 Most Difficult Places To Be A Mother Around The World

Being a mother isn't easy, no matter where you live. But American women have it easier than many others around the world, even as controversy swells around the health care system and maternal health in particular.

Save the Children's State of the World's Mothers 2014 report, released at the beginning of May, illustrates the shocking inequality mothers are subject to around the world. While some countries are blazing the path for social, medical and technological maternal health success, many others are struggling with soaring mortality rates and terrible birthing conditions.

Check out the 10 most difficult places to be a mother below, and check out the rest of the State of the World's Mothers report here.

  • #10: Cote d'Ivoire
    Colin Crowley/Save the Children
    Four generations of woman from one family are currently living in a crowded church building in the displacement camp of Duékoué, in Western Ivory Coast.

    They are (from left to right) Celestine Goulia, 50 years, her granddaughter Cyntish Oceane, 2 months, Celestine’s daughter Lydie Noelle, 28 years (holding Cyntish), and Celestine’s mother Helene Tieho, 70 years.

    The three women had to flee their homes with the infant Cyntish following recent fighting in the Western Ivory Coast. Lydie Noelle has recently been signed up for Save the Children’s programme to provide food for the several hundred pregnant and nursing mothers currently living in the camp. Save the Children has also chartered an emergency cargo plane to deliver urgently needed shelter items, including plastic sheeting, mosquito nets, buckets and water purification tablets to 5,000 displaced families in Ivory Coast.
  • #9: Chad
    UNHCR / F. Noy
    A mid-wife examines a pregnant refugee in the health center in Treguine camp in December, 2011.
  • #8: Nigeria
    Oiwoja Odihi/Save the Children
    Baby Yahya, seven months old, here with his mother Ramatu, was treated at the acute malnutrition ward of a government Comprehensive Health Centre in north Nigeria. The veins in this child's arms were too small to have intravenous drugs administered, so antibiotics were administered through an intravenous line to his head. He had been admitted eight days previously.

    This baby died the day after this photograph was taken.

    The mother had defaulted and left the clinic the day before the baby died, on advice of her sister-in-law, who had thought that the child's condition was not improving.
  • #7: Sierra Leone
    Jordi Matas/Save the Children
    Sixteen-year old Mariama gave birth to her baby on the side of the road in the dark in rural Sierra Leone. She woke up in the middle of the night with labor pains, and her traditional birth attendant advised that they go to the clinic that night.

    Without a flashlight or medical tools, she delivered her baby on the road. ‘The road was too long and I was feeling pain in my belly and I could not walk’, Mariama explained. She returned home with the umbilical cord still attached.

    The next morning, Mariama traveled to the health post. Mohamed, less than one month old, is healthy and his mother is "happy to have a baby boy." In sharing her experience, she stresses how she is "praying to god that they will come and build a hospital here" so that the "struggle will be over."

    Sierra Leone is in the bottom rankings of the Human Development Index, with high maternal and child mortality rates. It is often described as one of the worst places in the world to give birth or to be born. The Free Healthcare Initiative (FHCI) was introduced in 2010 for all pregnant women, lactating mothers and children under five, but while mothers no longer have to worry about the cost of giving birth access to healthcare facilities and vital medical supplies remains a challenge especially in rural areas.
  • #6: Central African Republic (CAR)
    Greg Funnell/Save the Children
    A mother with a three-week old baby in a displacement camp in a monastery in Bangui which houses thousands of IDPs sheltering from the sectarian fighting going on in Bangui, Central African Republic. 8th December 2013.

    As fighting and instability continues across the country, the humanitarian situation threatens to spiral out of control. To date, Save the Children has reached nearly 40,000 children, focusing on health, child protection and nutrition. In addition to our on-going humanitarian programs, we are currently supporting clinics and hospitals and setting up new child protection spaces in the capital, Bangui, to meet the needs of the thousands of people who have been displaced.
  • #5: Guinea-Bissau
    UNHCR/ B. Clarke
    Some 700,00 Liberians fled to neighboring countries when civil war erupted in late 1989. Ten years on, Guinea still hosts some 115,000 Liberian refugees. Most of the Liberian refugees who fled to Guinea were able to settle with the local population. Here, a refugee is helping with the coffee harvest. Daro, Macenta region.
  • #4: Mali
    Jonathan Hyams/Save the Children
    Awa waits at a health post with her son Modiba, two, for medication to treat severe malnutrition and malaria in Sakasso Region, Mali.

    Modiba weighs 5kg and is 70 cm tall -- 20cm shorter than he should be for his age.

    Sikasso region has particularly high levels of chronic malnutrition in children under five, although it is one of Mali's most productive regions. This is due to poor nutrition and high levels of export-oriented cash crop production.

    Save the Children trains and funds community health workers in the region to screen and refer children suffering from malnutrition. Save the children also run nutrition sensitization programs and has distributed seeds to the most vulnerable families to ensure longer-term food security.
  • #3: Niger
    Oli Cohen/Save the Children
    Someyla, one year old, with his mother Sarei at the stabilization center funded by Save the Children in Aguie' hospital.

    Someyla was referred to Aguie’ hospital from the village clinic because of severe malnutrition. He had diarrhea, coughing and fever for four days before he was brought to the clinic.

    The child also has indigestion problems and stomach reflux issues. This caused weight loss and malnutrition, alongside the lack of nutritious food at home.

    He received a systematic treatment for malnutrition including medicines, antibiotics, antimalarial drugs and therapeutic milk.
  • #2: Democratic Republic of Congo (DRC)
    Alessandro Pavone/ Save the Children
    Soleil, 20 years old, gave birth to both of her children in the bush, after she fled armed fighting in her village.

    Soleil had her first child when she was 16, and her 2nd one last March, after fighting broke out between a MaiMai group and the Government forces. She went into labor when she was in the fields, with only her neighbor to help her. They cut the umbilical cord with a razor blade. Fortunately, the baby was healthy and had no problems breathing. Soleil and her children returned to their village afterwards, but were displaced again in January 2014 when fighting between armed men broke out again. Her husband disappeared in the last bout of fighting.

    Soleil is now living with a host family in a neighboring village. “People are scared to come back to their villages, because armed men are still everywhere,” Soleil said. She has also heard that a number of women have been attacked and raped by armed men.

    She depends on the host family and neighbors for food, which she helps prepare, and has nothing left except the clothes she is wearing. “We get food by begging, asking for help when we arrive somewhere, or if you make a friend, he can help you with something to eat... I do not have even a sauce pan; it means I really have nothing.”
  • #1: Somalia
    Colin Crowley/Save the Children
    Makay Mohamed Aden arrived in Sigale from Afgoye when she was seven months pregnant. Makay was given an antenatal checkup at a Save the Children health clinic in Sigale IDP camp.

    Somalia’s economic and educational indicators are the lowest in the world. On maternal and child mortality it ranks second and fourth from last. And although Somalia does slightly better on political status, it's not enough to compensate for poor performance across the other four indicators. It is this placement in the bottom 5 on four of the five indicators that causes Somalia to rank last on the Index. As discussed elsewhere in this report, Somalia’s national level data mask sub-national variations.

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