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WASHINGTON (AFP) - The United States has scored poorly on a campaign group's list of the best countries in which to be a mother, managing only 28th place, and bettered by many smaller and poorer countries.
Norway topped the latest Save the Children "Mothers Index", followed by a string of other developed nations, while Afghanistan came in at the bottom of the table, below several African states.
But the US showing put it behind countries such as the Baltic states, Estonia, Latvia and Lithuania; and eastern and central European states such as Croatia and Slovenia.
Even debt-plagued Greece came in four places higher at 24.
One factor that dragged the US ranking down was its maternal mortality rate, which at one in 4,800 is one of the highest in the developed world, said the report.
"A woman in the Unites States is more than five times as likely as a woman in Bosnia and Herzegovina, Greece or Italy to die from pregnancy-related causes in her lifetime and her risk of maternal death is nearly 10-fold that of a woman in Ireland," the report said.
It also scored poorly on under-five mortality, its rate of eight per 1,000 births putting it on a par with Slovakia and Montenegro.
"At this rate, a child in the US is more than twice as likely as a child in Finland, Iceland, Sweden or Singapore to die before his or her fifth birthday," the report noted.
Only 61 percent of children were enrolled in preschool, which on this indicator made it the seventh-lowest country in the developed world, it said.
And it added: "The United States has the least generous maternity leave policy -- both in terms of duration and percent of wages paid -- of any wealthy nation."
Norway headed the list of developed countries at the top of the list of best places to be a mother, followed by Australia, Iceland, Sweden, Denmark, New Zealand, Finland, the Netherlands, Belgium and Germany.
At the bottom was Afghanistan, followed by Niger, Chad, Guinea-Bissau, Yemen, Democratic Republic of Congo, Mali, Sudan, Eritrea and Equatorial Guinea.
"While the situation in the United States needs to improve, mothers in the developing world are facing far greater risks to their own health and that of their children," said Save the Children's Mary Beth Powers.
"The shortage of skilled birth attendants and challenges in accessing birth control means that women in countries at the bottom of the list face the most pregnancies and the most risky birth situations, resulting in newborn and maternal deaths," she added.
Save the Children compiled the index after analyzing a range of factors affecting the health and well-being of women and children, including access to health care, education and economic opportunities.
Thus Norway came top because women there are paid well, access to contraception is easy and the country has one of the generous most maternity leave policies in the world.
Afghanistan however came last because of its high levels of infant mortality and the fact that it had the lowest female life expectancy and the worst rate of primary education for females in the world.
The report recommended more funding for women's and girls' education and better access to maternal and child health care, particularly in the developing world.
In the United States and other industrialised nations, it called on governments and communities to work together to improve education and health for disadvantaged mothers and children.