Some women in Sar-e Pol say that a lack of awareness about the importance of birth spacing, along with family pressure, beliefs, and traditions, has led them to have repeated pregnancies. They add that this has caused serious health problems and, in some cases, miscarriage.
Najila Mohammadi, a 34-year-old from Sar-e Pol city, says that although closely spaced pregnancies have caused her anemia and extreme fatigue, she has not gone to a doctor because of her husband’s family beliefs. She says,
“I have four children, and the gap between my pregnancies is short—about one to one and a half years. My pregnancies were not planned; they mostly happened because my husband and in-laws wanted more children. They believe the more children, the better. In fact, these pregnancies have had a very negative impact on me. I feel less patient, and with children coming one after another, I cannot take proper care of them. This has greatly affected my mental health. Sometimes my condition becomes very bad.”
Zahra, a 24-year-old from ‘Kangara Bagh’ village of Sar-e Pol, says she had a miscarriage due to repeated pregnancies and lack of information.
“I have three children now. The gap between them is usually about one year—they were born one after another. My pregnancies were unplanned, and I did not realize it. One of my pregnancies ended in miscarriage at four months because I was weak and anemic. After that, I felt mentally disturbed. My three children are also weak, and one of them has some neurological problems. I wish I had a little information,” she says.
Ay khanum, a 25-year-old, says that repeated pregnancies and pressure from her husband’s family caused her miscarriage.
“My husband tells me that I am jobless and should stay at home and take care of the children. My pregnancies usually happen after one year, meaning my children were born one after another. I became pregnant without planning. First, I felt mentally stressed, and second, when I saw a doctor, they said I was very weak and had severe anemia. I could not eat properly. My baby did not survive more than three or four hours after birth.”
Maryam, a 29-year-old, also says, “It has had negative effects. For instance, when a mother gives birth, she may lack iron and calcium for up to two years. During breastfeeding, these nutrients are used, and the body needs two to three years to recover and rebuild itself. Personally, I tried many times to space my pregnancies, but I could not.”
Meanwhile, some women in Sar-e Pol who have maintained a proper gap between pregnancies say they are healthier and more satisfied with their lives.
Halima, a 25-year-old, says that by gaining awareness, maintaining a three-year gap between births, and using contraceptive methods, she has been able to protect her physical and mental health as well as that of her family.
“I have two children. I was 19 years old when I got married. There is a three-year gap between each of my children. Yes, I used preventive methods. As you know, technology has developed, and medicines and methods to prevent pregnancy are available. I used preventive methods, and now my children can benefit from breastfeeding and complementary foods, so their mental and physical health is completely developed,” she says.
Marjan, a 30-year-old, also says, “We had information about pregnancy and birth spacing before. Before getting pregnant and during pregnancy, we visited clinics and became aware of these issues. I kept this information in mind. For having children, we tried to make decisions together and consult each other, and we planned when to have children. The awareness and the decisions we made were mutual; this helped maintain balance.”
At the same time, a number of obstetrician-gynecologists emphasizing the importance of spacing between births to protect the health of both mother and baby, warn about the dangerous consequences of closely spaced pregnancies. Atefa sadid, an obstetrician-gynecologist, says,
“Controlling pregnancy is not just a choice; it is an essential requirement for the health of both mother and child. When pregnancies are too close, the mother’s body does not have enough time to recover. This can cause anemia, weakness, and may increase the risks in subsequent pregnancies. Children born with proper spacing are usually healthier. The main problem is a lack of awareness, meaning women do not know how to use preventive methods, as well as limited access to healthcare.”
Sadia Gilani, another obstetrician-gynecologist, says, “The considered gap between births is at least 18 to 24 months. The problems that it creates for mothers include causing anemia, because the mother’s iron stores become depleted, which leads to more severe anemia. Anemia can cause weakness and serious fatigue in mothers, and it may also lead to high blood pressure during pregnancy. Maintaining proper spacing between pregnancies has more benefits for both the mother and child. It also has a positive impact on society and the family.”
Qutbuddin Mujtahid, a religious scholar, also says that, in order to protect the health of the mother and the fetus, a gap of about two years between births is considered a Sharia principle.
“Islam encourages women to have children, but at the same time, protecting the health of the mother and child is an important Sharia principle. Therefore, if a subsequent pregnancy causes harm or difficulty, spacing or family planning is permissible according to religion. Islam does not specifically determine a number of years; however, it is mentioned in the Holy Quran that the period of breastfeeding is two years, meaning the child should be breastfed for two years. It is better not to become pregnant again during this breastfeeding period.”
We wanted to obtain the views of officials at the Sar-e Pol Public Health Directorate; however, despite repeated calls, we were unsuccessful. According to World Health Organization statistics from 1403(2024), 638 mothers die for every 100,000 births in Afghanistan. Health experts say the main reasons for this situation are lack of access to adequate maternal healthcare services, lack of awareness among families about birth spacing, and repeated pregnancies.
Reporter: Sabrina Gunish
