Afghanistan violence threatens pregnant women, mothers

A struggle for women to access maternal healthcare

DAND, Afghanistan (AFP) --—Married to a much older man in Afghanistan, Wati — who thinks she is around 30 years old — is pregnant for a fifth time in four years, including two miscarriages.

She has traveled by car to a government-run maternity clinic in a poor and rural village in southern Kandahar province, the birthplace of the Taliban.

“I am afraid I will lose the baby again,” she tells AFP, a small bump showing on her frail frame.

Decades of conflict and poverty have long made it a struggle for women to access maternal healthcare in deeply patriarchal Afghanistan.

Clinics often too far away.

With the withdrawal of US-led foreign forces and escalating violence, there are signs it could become even more difficult, with thousands of women displaced, roads increasingly too dangerous to travel and international aid drying up.

At the clinic in Kandahar, women in burqas arrive accompanied by male relatives, who are barred from entering and wait outside on the grass.

“I only have permission to leave the house to go to the doctor,” says Wati, clutching her medical notes in a plastic bag.

With five children, fellow mother Khorma has also had two miscarriages and is worried after discovering she is pregnant again.

“I worked too hard at home,” she said during a visit to the clinic in Dand district, before the Taliban launched its latest sweeping offensive across the country.

Giving birth at home

Forty-one percent of Afghan women give birth at home and 60 percent have no postnatal care, according to a 2018 study by the KIT Royal Tropical Institute, based in the Netherlands.

The statistics are worse in the south, the region worst affected by decades of conflict, with clinics often too far away or requiring expensive transport through dangerous areas.

“Some families don’t care about pregnancies: the women give birth at home, start bleeding too much and go into shock,” says Husna, a midwife.

Although healthcare has improved — mainly in cities — insecurity and poverty still have a devastating impact.

The United Nations children’s agency UNICEF recorded that 7,700 women died in childbirth in 2017 — twice the number of civilians killed in political violence that year.

In the dusty village of Qasem Pul, midwife Najia goes house-to-house, monitoring women through their pregnancies.