Click here to read this article in The Borgen Project
Orange County, CA—Afghanistan has one of the top 10 highest maternal mortality rates worldwide. Pregnant Afghan women are 30 times more likely to die during childbirth than pregnant women in the United States (U.S.). There are various factors currently impacting childbirth safety in this Middle Eastern country.
Sociopolitical Factors
Britannica’s profile on Afghanistan describes how the country takes the impact in political and commerce disputes. These conflicts have led to warfare and various changes in the regime within Afghanistan. These recurrent periods of transitional leadership followed and brought with them uncertainty and civil unrest.
Britannica also reported that “Afghanistan has one of the least-developed health care systems in the world,” with only a small number of Afghans having access to health care. Britannica also highlighted that government-issued medical services are minimal, as “medical training is nonexistent” within the country.
In “Maternal Mortality in Afghanistan: Challenges, Efforts and Recommendations,” an academic paper by a group of medical scholars on maternal death in Afghanistan, it was revealed that political instability and violence have harmed the health care system. These scholars also found that female health care staff trained in assisting during child labor are often “not allowed to report to their posting by the Taliban” and that there has been an increase in violence against midwives in the country.
According to reports, the Taliban seized power, international donors withdrew funds that the health care system in Afghanistan previously relied upon. These are just some of the aspects of Afghanistan’s unstable sociopolitical state currently contributing to maternal death in the country.
VOANews reported that “despite the country’s improved maternal mortality rates between 2001 and 2021,” the resurgence of the Taliban following this period has derailed that hard-won progress. This is both due to the Taliban’s restriction of midwives attending to their posts and the fact that nearly 90% of Afghans “suspended or decided not to seek medical care in 2022 mostly because of Taliban restrictions and poverty.”
The Impact of a Lack of Resources
UNICEF has highlighted that maternal death in Afghanistan as a result of preventable causes due to poverty is an urgent humanitarian crisis as this Middle Eastern country remains one of the most dangerous places in the world for mothers during child labor. “UNICEF explained, ‘Thousands of Afghan women die every year from pregnancy-related causes,’ a majority of which can be easily preventable.”
The organization described how one of the most common contemporary factors contributing to this crisis is access to a hospital or health facility being beyond the reach of most pregnant mothers in the country. UNICEF concluded that the majority of maternal deaths in Afghanistan are preventable. In the article “Social Determinants of Maternal Health in Afghanistan,” public health scholars reviewed the state of the country’s maternal death crisis. These scholars found that the most common medical conditions contributing to this crisis were “hemorrhage, obstructed labor, infection, high blood pressure” and other medical conditions that could be prevented or better treated with secure access to professional medical care.
Registered Nurse First Assistant Kinshasha Johnson, with more than a decade of labor and delivery experience, discussed the importance of access to medical care during childbirth in her interview with The Borgen Project. Johnson highlighted that medical professionals have access to resources like fetal monitoring, supplemental oxygen, IV fluid hydration, methods to stop contractions and even surgical intervention if necessary. These and other resources that medical professionals provide during child labor can treat many of the conditions listed as contributing heavily to maternal death in Afghanistan.
When asked whether she had something she wanted the world to know about poverty and maternal mortality, RNFA Johnson highlighted that pregnant women living in poverty without access to medical resources “often have to live with things that can be easily avoided.” She added that the women also often go “undiagnosed for medical conditions that could lead to maternal emergencies.”
Midwifery in Afghanistan
Midwives throughout the Middle Eastern country are working to improve the reality of maternal death in Afghanistan. In their article “Midwives on the Front Lines Working to Reverse Afghanistan’s High Maternal Death Rate,” The United Nations Population Fund (UNFPA) highlighted the Community Midwifery Program and their work in training “midwives to provide essential basic maternal health services and other midwifery care.”
The UNPFA plays a crucial role in these efforts and “supports Afghanistan’s Community Midwifery Education Programme ” in various ways. Midwives educated through the program operate out of “UNFPA-established family health houses,” which the UNFPA founded to provide medical resources for Afghanistan’s most vulnerable populations.
Takeaway
Maternal mortality in Afghanistan is an ongoing humanitarian public health crisis with many contributing factors. Most prominently, civil unrest and conflict within the country and its unstable sociopolitical state have hindered the country’s ability to establish a reliable infrastructure. As a result, insecure access to professional medical assistance is a concern for a majority of the population, including pregnant women. Because of this, there has been an establishment of community education in midwifery in some regions of the country as a means of alleviating the high rate of maternal death in Afghanistan.
—Rosemary Wright
