No More Midwives

Text and photos by Noriko Hayashi/Panos Pictures
Abridged by Syharn Shen (沈思含)

Afghanistan has one of the highest maternal mortality rates in the world. Facing years of conflict and humanitarian aid, local midwives are struggling to save lives.

Midwife Anisa (24) applies a Pinard stethoscope to the abdomen of a 9-month pregnant mother to check the fetus’ heartbeat. She is part of a mobile health team that travels to villages without medical facilities.

Afghanistan has one of the highest maternal mortality rates in the world. Years of conflict and a worsening humanitarian crisis have left local midwives struggling to save lives. With foreign aid drastically reduced, many women in remote areas are forced to give birth without medical assistance, risking their lives and those of their babies.

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In Badakhshan Province, a remote mountainous region, 28-year-old midwife Khadijeh works tirelessly in a small village clinic. She is the only midwife serving 15 villages, home to about 6,000 people. On a cold November morning, she rushes to revive a newborn who was limp and not breathing. The baby’s mother, Asia, had labored at home for three days before making a difficult three-hour journey to the clinic. Khadijeh resuscitates the baby, and after tense moments, a faint cry fills the room. Outside, about 50 pregnant women wait for her care.

A newborn baby, delivered to Asia, a 20-year-old mother, was not breathing when born and had to be resuscitated by midwife Khadijeh. It is now weighed after recovering sufficiently.

Badakhshan has one of the highest maternal mortality rates in Afghanistan. Women face dangerous childbirth conditions due to heavy snowfall cutting off roads, a severe shortage of midwives, and child marriages that lead to early pregnancies. The province has about 200 midwives, far below the World Health Organization’s recommendation. Many births are assisted by untrained relatives, increasing risks. The Taliban’s rule has further restricted women’s mobility, making it harder for them to reach healthcare facilities.

Women walking along a mountain path. A large part of Badakhshan Province, home to about one million people, is rugged mountainous terrain. In winter, the roads are closed for months due to heavy snowfall, making access to medical facilities difficult.

To address these challenges, the United Nations Population Fund (UNFPA) has deployed mobile health teams. These teams travel to villages with no medical facilities, providing care to pregnant women. Anisa, a 24-year-old midwife, is part of one such team. She visits expectant mothers in remote villages, ensuring they receive essential prenatal checkups. Despite harsh conditions, she remains committed: “Just being able to save one life makes this work worthwhile.”

Young women participate in a two-year midwifery training program run by UNFPA. They will return to their home villages to work as midwives after completing their training.

A midwifery training program, run by UNFPA, is equipping young women with the skills to assist births in their home villages. Despite bans on secondary education for girls, midwifery remains one of the few professions women can study. Graduates from this program are a beacon of hope for reducing maternal mortality in Afghanistan.

For many Afghan women, the dream of an education and career has been shattered by the Taliban’s restrictions. A 19-year-old woman, once aspiring to be a politician, now spends her days at home doing household chores. “I love my country, but I feel I have no future here,” she says.

A 19-year-old woman, unable to pursue higher education due to the Taliban’s restrictions, reflects on her lost dreams.

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