For Afghan Women, Giving Birth Still Poses a Deadly Risk

For Afghan Women, Giving Birth Still Poses a Deadly Risk - TIME window.fbAsyncInit = function() { FB.init({ appId: "53177223193", cookie: true, // these two are not required for partners that status: true, // only rely on stk plugins and don't use connect xfbml: true });};(function() { var e = document.createElement('script'); e.async = true; e.src = document.location.protocol + '//connect.facebook.net/en_US/all.js'; document.getElementById('fb-root').appendChild(e);}()); Home TIME Magazine Photos Videos Specials Topics Subscribe Mobile AppsNewslettersRSS @TIME NewsFeed U.S. Politics World Business Money Tech Health Science Entertainment SEARCH TIME.COM Full Archive Covers Videos Main Global Spin Travel Intelligent Cities Videos Birth and Death: Afghanistan's Struggles with Maternal Mortality By Joanna Kakissis / Kabul Tuesday, Oct. 11, 2011 Salamudin, 36, center, waits at a pharmacy in the Afghan town of Bamiyan on May, 30, 2011, with his wife Bakhtawar, 22, and their 1-year-old son Surodin. Salamudin allowed his wife to give birth in a hospital

Ted Richardson Comment Print EmailReprints share LinkedInStumbleUponRedditDigg Del.i.cious Tweet

When Fawzia went into labor with her fifth child, she knew something was wrong. She felt like her insides were being ripped apart by knives. She bled so much that her clothes were soaked. "I did not want to die," recalls Fawzia, 25, who, like many rural Afghans, only uses one name. "I prayed and hoped the pain would go away. But when it didn't, I asked to go to a hospital."

Fawzia, an ethnic Hazara from Jaghori district in the volatile center-east province of Ghazni, had never been to a hospital, and says she had no idea where to find one. She had given birth to her other children at home, and the closest clinic is a two-hour drive away. When she got there, the staff said they couldn't help her. Go to Kabul, they said. It took another 10 hours to drive to Rabia Balkhi, a women's hospital in central Kabul that offers free services to impoverished women. (See pictures of Afghanistan's dangerous Korengal Valley.)

By then, Fawzia had lost so much blood that doctors were worried she wouldn't make it. Dr. Taiba Motaqi, 30, a resident in obstetrics, knew right away that the young woman had a ruptured uterus. The complication is rare among pregnant women in the developed world, but it kills many Afghan women each year. Fawzia underwent an emergency C-section, a common procedure at Rabia Balkhi Hospital. "Women come here with problems like this at the very last minute," Dr. Motaqi says. "We have to work quickly to save them."

When Fawzia got married 10 years ago, the Taliban were still running Afghanistan, and women's rights were at a nadir. Most women gave birth at home, and the few who managed to venture to hospitals often discovered that the facilities were understaffed and lacked equipment and medicine. In late 2001, the U.S.-led military campaign pushed the Taliban out of power, and since then, millions of dollars in U.S. and foreign aid have gone to help build clinics and hospitals and train health workers. It was supposed to be a new beginning for Afghan women marginalized by the Taliban's brutal and theocratic rule. But a decade later, Afghanistan still ranks as the worst country in the world to be a mother. (See pictures of the battle against the Taliban.)

About 18,000 Afghan women die during childbirth every year, says the Afghan Health Ministry. According to a recent report by the NGO Save the Children, Afghanistan ranked as the worst place to give birth, followed by Niger and Chad. In these countries, 60% of all births are not attended to by skilled health professionals. On average, about 1 in 23 mothers are expected to die from pregnancy-related causes. Children also die young and suffer from malnutrition, and education for girls is poor.

Often the challenge is just getting women to hospitals. Rural Afghans, even in relatively progressive provinces like Bamiyan in central Afghanistan, are suspicious or dismissive of doctors. In the town of Bamiyan, the main hospital has a new maternity ward. But head midwife Sediqa Hosseini says many of the 25 beds in the ward are often empty. On a recent summer afternoon, Hosseini, a tiny, serious woman in a baby blue headscarf, greets the 12 women who have checked in. One is Fatima, a 25-year-old farmer's wife. "When Fatima arrived, her baby was coming out shoulder first," Hosseini says. "She had to have a C-section. Without help, both of them would have died."

Fatima says her husband took her to the hospital when her labor became so painful that she was doubled over. Hosseini says few husbands would have done the same. Many rural men prefer to pray with a mullah to cure illnesses, she says. "They believe this is more reliable than medicine." As she breast-feeds her newborn daughter, Fatima says she wouldn't have gone if it had not been for a community-health worker who told her hospitals are safe and free.

Adding to the problem is that rural Afghan women are also conservative, and some are ashamed of being pregnant because it's a public acknowledgement of sex with their spouses, says Gulpari, a midwife in Bamiyan's remote Sayghan district. Sayghan is a dusty, wind-lashed stretch of bare mountains, cratered dirt roads and some 60-odd villages of compact mud huts. Gulpari lives in the village of Khudadadkhel, where she works at the small, understaffed Sayghan clinic that mostly treats stomach ailments and lung diseases.

See pictures of the work of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

1 2 NEXT PAGE » Comment Print EmailReprints share LinkedInStumbleUponRedditDigg Del.i.cious Most Popular »Full List » MOST READ MOST EMAILED In Some Chinese Hospitals, Violence Is Out of Control and It's Doctors Who Are At RiskScientists '95% Sure' Bigfoot Lives in Russian TundraNew Proof That Comets Watered the EarthWhy You Should Worry About China's Real Estate Bubble BurstingSteve Jobs, 1955?2011: Mourning Technology's Great ReinventorTeacher, Leave Those Kids Alone: A Look at South Korea's Education SystemThe Honeymoon's Over: Sicily Cracks Down on Weddings ReceiptsBirth and Death: Afghanistan's Struggles with Maternal MortalitySteve Jobs: Remembering the Dissatisfied ManRomney in Debate: I Can Work with 'Good' Democrats Teacher, Leave Those Kids Alone: A Look at South Korea's Education SystemScientists '95% Sure' Bigfoot Lives in Russian TundraIn Some Chinese Hospitals, Violence Is Out of Control and It's Doctors Who Are At RiskWhy You Should Worry About China's Real Estate Bubble BurstingFoster Care: Extreme EditionWhat You Need to Know About ... Nuts, Beans & OilsMedicine: New Labels for FoodComing Together to Kill Education ReformSteve Jobs: Remembering the Dissatisfied ManSteve Jobs, 1955?2011: Mourning Technology's Great Reinventor More News from Our Partners CNN Syria opposition gains regional backers Captain of ship spilling oil off New Zealand charged Source: Top Egyptian official resigns Huffington Post A Man Among MachinesSteve Jobs Dead: Apple Co-Founder Dies At 56Sarah Palin Makes Decision On 2012 Time.com on Digg Upcoming Popular Today POWERED BY digg

Related PhotosPhotos: Taking the Fight to the Taliban PhotosAccess to Life StoriesTaliban Strikes Undermine U.S. OptimismDespite the Election, It's a Failing Cause in Afghanistan Newsfeed Amy Winehouse's Father Will Write Memoir, Donate Proceeds to Charity NBA Lockout: First Two Weeks of the Season Gone. Now What? Japan to Give Away 10,000 Free Flights to Tourists in 2012 More on TIME.com Chicago Ideas Week 2011: Intelligence Squared Top 10 Nobel Prize Controversies Top 10 Topical Sesame Street Characters Techland New Version of iTunes Available, iOS 5 Update Coming Tomorrow U.K. ISPs Deny Automatic 'Parental Control' Rumors Adobe Shows Off Blurry Picture Fix in Photoshop Moneyland “Volcker Rule” Officially Proposed, Forbidding Banks From Trading For Profit — And Angering Them Latest Housing Bust Casualty: Babies ING Direct Account Openings Skyrocket After BofA, Citi Fee Hikes Top Stories on TIME.com In Some Chinese Hospitals, Violence Is Out of Control and It's Doctors Who Are At Risk The Israel-Hamas Prisoner Swap: Who Wins in the Freeing of Gilad Shalit? Iran's Alleged Assassination Plot: Surveying the Political Fallout Quotes of the Day » "They"ve got to win two more. We"ve got to win four. It"s pretty simple math." JIM LEYLAND, manager of the Detroit Tigers, on his team’s challenge to come back after being down two games to zero in the American League Championships as the series moved to Detroit; the Tigers won the third game 5-2 More Quotes » For use in rail of Articles page or Section Fronts pages. Duplicate and change name as necesssary to distinguish. Stay Connected with TIME.comSubscribe to
RSS FeedsSign Up for
NewslettersGet the TIME
Magazine iPad EditionRead TIME Mobile
on your PhoneBecome a
Fan of TIMEGet TIME
Twitter Updates NewsFeed U.S. Politics World Business Money Health Science Entertainment Photos Videos Specials Magazine © 2011 Time Inc. All rights reservedPrivacy PolicyRSSNewsletterMobileTIME For KidsLIFE.com SubscribeContact UsTerms of UseMedia KitReprints & PermissionsHelpSite MapAd Choices TIME Our partners CNN CNN MONEY LIFE