For women of Afghanistan, pregnancy and delivery are dangerous. The war torn country has the “world’s second-highest death rate in women during pregnancy and childbirth”, second only to another war torn country Sierra Leone. The medical journal Lancet reports that 78% of these maternal deaths could be avoided. The New York Times reports:
For every 100,000 births, 1,600 mothers die; in wealthy countries the rates range from 1 to 12. In one remote northeastern province, Badakhshan, 6,507 mothers die for every 100,000 births, according to a 2005 report in the medical journal Lancet. In all, 26,000 Afghan women a year die while pregnant or giving birth. The main causes of these deaths are hemorrhage and obstructed labor, which can be fatal if a woman cannot obtain a Caesarean section. Even if the mother survives, obstructed labor without a Caesarean usually kills the baby.
Midwives in Afghanistan may be the solution. Increasing the number of midwives in the country would help the 80% of Afghan women who give birth without “skilled help”, but the profession needs rebuilding. According to Afghan midwife Pashtoon Azfar, president of the Afghan Midwives Association, midwifery was once a well-respected profession in the country, but war caused many medical professionals to flee, including herself.
By the time she returned to Afghanistan, she said, midwifery was in a shambles. Spots in professional schools of all kinds were being filled by people with political connections instead of those with good grades. The midwives who had stayed behind had not received any continuing education. Their skills were outdated, and their attitudes were even worse. “A culture of war was going on,” Ms. Azfar said. “If a mother came for delivery they didn’t treat her as she deserved or needed to be treated. There was no emotional support.”
I feel fortunate to have been treated with respect, compassion, and love by the midwives that delivered my babies. It was one reason why I chose a home birth over a hospital birth. I hope Ms. Azfar can be successful returning the profession to its pre-war status for the women of Afghanistan.