A number of obstetricians and gynecologists at Malalai Hospital say that premarital counseling is important for both girls and boys, and that examinations such as blood group and Rh factor, hormonal tests, spermograms, evaluations of male and female reproductive health, and uterine health checks are essential before marriage.
They add that not paying attention to, and neglecting premarital counseling can, in some cases, lead to problems such as infertility and miscarriage in the future.
Adela Achakzai, a gynecologist and obstetrician, says, “Premarital counseling is very important for a couple’s life. For men, examinations such as a spermogram should be conducted to ensure their reproductive health is not weak. For women, hormonal examinations should be performed, and blood group and the Rh factor, is very important. If the Rh factors are incompatible, couples should receive counseling in advance to help ensure they can have healthy children in the future.”
Sunita Bahram, another obstetrician and gynecologist, says that premarital counseling plays a key role in preventing infertility and miscarriage. Checking hormone levels and uterine health before marriage can reduce health problems for mothers in the future. She says,
“Examining hormones and uterine health before marriage is very important. If hormone balance is abnormal, it can cause infertility, repeated miscarriages, ovarian cysts, excessive hair growth, or acne. Timely counseling with an obstetrician-gynecologist can significantly reduce health problems for the mother in the future.”
However, women interviewed for this report said that, due to not receiving premarital counseling and neglecting medical examinations, they have faced serious challenges. They emphasized that not receiving premarital counseling has not only caused health problems but has also affected their married life.
Nafisa, a 24-year-old from Kabul, says that she did not visit any medical center for premarital counseling and did not get pregnant for ten years after her marriage. Now, at nine months pregnant, doctors say that the chances of her baby surviving are low due to the fetus’s weakness.
She explains, “I never went to health centers for counseling before marriage. From age 14 to 24, I could not get pregnant. Now, after ten years, I have gotten pregnant and am on bed rest in the hospital. I am 34 weeks pregnant, and my child is premature. Doctors say the fetus is so weak that its chances of survival are very low,” she says.
Mozhgan, a 36-year-old from Kabul, says that not receiving premarital counseling not only caused her health problems but also affected her marriage. After several years of enduring hardship, her marriage fell apart. She says,
“I had never visited a health center before marriage. At first, I couldn’t get pregnant at all. I went to Pakistan for treatment, but it didn’t help. When I couldn’t get pregnant, my husband and his family said he should take a second wife. Seven years later, my husband married again. Two years after that, he divorced me. I had no choice but to return to my father’s house.”
Basira, a 29-year-old from Kabul, also experienced psychological challenges due to not receiving premarital counseling and facing various problems. She says,
“I never visited health centers before marriage, and after marriage, I could not get pregnant for two years. This caused many problems in my life. Premarital counseling is very helpful, especially for checking one’s blood health. Visiting a doctor before marriage is extremely important. I developed psychological problems because the issue was my husband’s, not mine. My husband was weak.”
Frozan Dawoodzai, women’s rights activist, says that a woman’s inability to get pregnant does not reduce her rights over her husband. In some families, incorrect beliefs cause women to bear more challenges because of infertility.
“In Islam, regarding marriage and spouse selection, if a woman is infertile, it does not mean she loses her rights over her husband or should be insulted. But in Afghan society, due to incorrect traditions, such behavior occurs and is considered a form of violence,” she adds.
Qutbuddin Mujtahid, a religious scholar, says, “From the Hanafi jurisprudence perspective, conducting premarital counseling and medical examinations is not only permissible but, in many cases, recommended (Mustahib) or even necessary. Medical examinations are among the means of preserving health and are therefore allowed.”
We attempted to obtain the perspective of the Ministry of Public Health of the Islamic Emirate regarding the services it provides in the area of family counseling, but despite repeated efforts, we were unsuccessful.
In Afghanistan, despite the importance of marriage, attention to premarital counseling and medical examinations has not yet become institutionalized. Poverty and traditional beliefs are among the contributing factors, and this neglect has, in many cases, led to serious health and social consequences, particularly for women.
Reporter: Husna Sadat
