This combination of two images taken between March 16, top, and Aug. 11, shows Syrian refugee Wazeera Elaiwi, 29, posing for a picture while being pregnant, and after giving birth to her child, at an informal tented settlement near the Syrian border, on the outskirts of Mafraq, Jordan. Refugees who live in makeshift camps, like this one near the Jordanian town of Mafraq, face even more dire choices to be able to live close to their jobs on local farms or to have greater freedom. — AP MAFRAQ, Jordan — Here among the tents of this informal camp for Syrian refugees in Jordan, pregnant mothers have given birth to children they struggle to care for amid sandstorms and crushing poverty. More than 4 million Syrians have fled their country and are now registered as refugees, according to the United Nations. Most face desperate circumstances, even in Jordan's registered camps like Zaatari. But those who live in makeshift camps, like this one near the Jordanian town of Mafraq, face even more dire choices to be able to live close to their jobs on local farms or to have greater freedom. Many of these women The Associated Press previously profiled and photographed for a story in March about their lives as pregnant refugees. Now months later, Muhammed Muheisen, the AP's chief photographer for the Middle East, Afghanistan and Pakistan, returned to see how their lives had changed since the birth of their children. The challenges they face are laid bare by Syrian refugee Wadhah Hamada, 22, who just gave birth to her first son, Ra'fat: “Winter is so cold, summer is hot and dry. My husband hardly works and some of the decisions we had to make have been deciding what is more important: To buy bread to feed ourselves or medicine in case my child is in need? A day of treatment for my baby who suffered from diarrhea is like a month of work for my husband.” Here are some stories of their survival: A SUDDEN SANDSTORM Taleea Farhan, 33, from Daraa, Syria, said her fifth child, son Belal, born among the tents of Mafraq, was in good health until the day a sandstorm swept through their camp. “Our tent fell on us. I picked up my newly born child in my arms and ran with my other children randomly till we all hid ourselves in a neighbor's tent for two hours till the storm calmed down,” Farhan recounts. “During these two hours we didn't stop crying, it was so scary. Up to now, all my children are suffering from infection from the dust.” Mona Hussein, 33, from Hassakeh , Syria, gave birth to her daughter Zahra, her third child, just before the sandstorm as well. “We are left alone. No one comes to check on us. We live by the roadside,” Hussein says. “The day the storm a few weeks back I thought we are all going to die. I held my child and didn't stop crying.” MOUNTING MEDICAL BILLS Khalida Moussa, 28, who came to Mafraq from the countryside of Syria's capital, Damascus, recently gave birth to her son Abdulelah, her fourth child. “I delivered several days after my due day and I was so afraid,” Moussa says. “We had to borrow money for me to deliver and up to now my husband hasn't paid it back. He can't afford it.” Feedah Ali, 18, of Ghouta al-Sharqiya, Syria, gave birth to her first daughter, Khadija, on Aug. 14. She also fears looming medical bills. “We left Syria two years ago with nothing and today we have nothing, I wish someone could turn to us, help us, take us out of our misery,” Ali says. “I woke up next day wondering how I will raise my daughter in this tent. What will I do if she gets sick?“ DESPERATION Bushra Eidah, 16, also from Ghouta al-Sharqiya, knew life would get harder with the birth of her daughter Salam, but she still feels disappointed in this “unfair world.” “We used to be two and now we are three,” Eidah says. “When it was only me and my husband, it didn't matter if we went to sleep hungry, but now we have a child and I don't know how we are going to feed her.” Mahdiya Alkhalid, 36, from Hama, Syria, also worried about the future when she was pregnant with her second daughter, Mariam. Now that Mariam is 4 ½ months old, the challenges seem even greater. “We are the ones who live outside of the registered camps with miserable conditions,” Alkhalid says. “My husband has no work. All we want is people to help us and pay us some attention.” And Huda Alhumaidi, 30, also from Hama, simply doesn't know what to do after the birth of her seventh child, Islam. “I'm speechless, I have no words left,” Alhumaidi says. “We are done complaining and begging for help. We are abandoned here. I just want to go back to my country. Even if we have to start from zero there as we lost our home, at least we will be able to live with dignity.” WARY HOPE FOR THE FUTURE But not all is lost for these mothers who live among the tents, like Huda Alsayil, 20, from Hama. After delivering her first son, Mezwid, despite fears of medical complications, Alsayil says she now feels “complete” for the first time in months. “Holding him feels like the best gift I could be granted,” she says. — AP