Postpartum bleeding, high blood pressure, and limited access to healthcare services are among the most important causes of maternal deaths in Afghanistan. This finding is based on interviews with the families of victims, doctors, international organizations, and the Ministry of Public Health. In this report, Salam Watandar interviewed 15 families, international organizations, doctors, and the Ministry of Public Health of the Islamic Emirate.
What warning signs did mothers experience before childbirth?
Among the 15 families interviewed, six mothers died due to high blood pressure, three died as a result of seizures, and six others lost their lives because of severe postpartum bleeding. The families’ stories show that many of these women experienced severe weakness, dizziness, blurred vision, high blood pressure, and severe headaches—particularly during the ninth month of pregnancy—before giving birth.
Mohammad Rahim, a 34-year-old resident of Taywara District in Ghor, lost his 25-year-old wife last year due to severe postpartum bleeding.
“She had two children, and this was her third pregnancy. She had reached the ninth month of pregnancy. She suffered from anemia and often complained of weakness and dizziness. She was also taking medication, but her condition was not improving. When severe labor pains began, the local midwife came first. Later, when the bleeding became heavy, we immediately took her to the hospital. The doctors tried to save her and even provided her with blood, but the bleeding had become severe. The heavy postpartum bleeding caused her death,” he says.
Abdul Ghafoor, a 55-year-old resident of Farah who lost his daughter eight months ago during childbirth due to complications caused by high blood pressure, says that his daughter had swollen feet and high blood pressure before delivery but was transferred to the hospital too late.
The United Nations Population Fund in Afghanistan (UNFPA) says that women living in remote areas, those from low-income families, internally displaced people, returnees, and young women are among the groups most vulnerable to maternal mortality.
Hedayat-ul-Haq Hedayat, a media and communications analyst at UNFPA, tells Salam Watandar,
“Existing evidence shows that the main causes of maternal mortality between 2021 and 2025 include postpartum bleeding, complications caused by high blood pressure during pregnancy, infections (sepsis), prolonged or obstructed labor, anemia, malnutrition, and delays in accessing emergency obstetric care. Women living in rural and remote areas, those from low-income families, returnees, internally displaced people, and girls and women with limited access to skilled midwives or healthcare workers during childbirth face the greatest risks.”
Why do some mothers not have access to healthcare services before and after childbirth?
The findings of this report show that limited access to healthcare services is one of the most important causes of maternal deaths in Afghanistan. Among the 15 families interviewed, 13 living in rural areas said that the distance to health centers, financial difficulties, the lack of well-equipped clinics, the shortage of female doctors, and poor road conditions prevented mothers from receiving the necessary care during pregnancy and after childbirth.
Shakila, a 31-year-old resident of Yawan District in Badakhshan, says that three years ago, her brother’s wife died due to a lack of access to necessary healthcare services during pregnancy and after childbirth.
“She did not visit a doctor regularly. The clinic was far from our village, and we could barely afford the transportation costs. She always complained of weakness and dizziness. When her pain and bleeding became severe, we urgently tried to take her to the hospital, but finding a vehicle was not easy, and it took nearly three hours to get there. If there had been a better-equipped clinic or if we had taken her to a doctor earlier, perhaps she would have survived,” she says.
Zahra, a 25-year-old resident of Ab Kamari District in Badghis, whose sister died during childbirth two and a half years ago, says,
“There was no doctor in our area. We had to travel a very long distance to other villages where doctors were available. My sister’s husband’s family said they did not have enough money to travel. They also did not have a car or motorcycle to take her. After her bleeding became very severe, she died.”
The UNFPA also says that the gap between urban and rural areas in access to prenatal care, the shortage of skilled health workers during childbirth, and the low rate of births in health centers have caused women in rural areas to face greater barriers in accessing healthcare services.
How do social beliefs threaten the lives of pregnant women?
Five families interviewed for this report said that, because of certain prevailing social traditions and a shortage of female doctors, their family members were unwilling to take pregnant women to see a doctor for medical care. According to these families, these delays ultimately contributed to the women’s deaths.
Maryam, a 24-year-old resident of Qarghayi District in Laghman, says that her sister died during childbirth because of traditional beliefs and delays in seeking medical care.
“She had reached full term and completed nine months of pregnancy. Because of traditional beliefs and the shortage of female doctors, she was unable to see a doctor. When her labor began, she experienced severe bleeding. The roads were in poor condition and unpaved, and the hospital was far away. By the time we arrived, it was too late. The doctors tried to save her and gave her blood transfusions, but the hospital lacked adequate facilities,” she says.
Noor Ahmad Salim, head of the media department at Medecins Sans Frontieres (MSF), also tells Salam Watandar that women in Afghanistan face social and cultural barriers in accessing healthcare services.
“The rise in poverty, weaknesses in the healthcare system, and shortages of funding, specialized staff, medical equipment, medicines, and other medical supplies are among the key factors contributing to this situation. Other challenges include difficulties in transporting patients, a shortage of primary healthcare centers, reduced funding for health services, and the cost of treatment. In addition to these challenges, women also face social and cultural barriers that limit their access to timely primary and specialized healthcare services,” he says.
What solutions do doctors suggest to reduce maternal mortality?
Specialist obstetricians and gynecologists say that maternal mortality in Afghanistan is not caused by medical problems alone. Rather, it results from a combination of geographic challenges, a shortage of healthcare facilities, and poor access to medical services.
They believe that deploying trained midwives to remote areas, raising families’ awareness of pregnancy and childbirth care, and strengthening the facilities and equipment of health centers are among the most important measures to reduce maternal deaths in the country.
Abeda Raha, an obstetrics and gynecology specialist, says in an interview with Salam Watandar,
“From a medical perspective, bleeding and infections account for 56 percent of the primary causes of maternal mortality. Other primary causes include unsafe deliveries, the involvement of unqualified birth attendants, high blood pressure, and complications during childbirth. Malnutrition can also contribute to severe bleeding. The shortage of specialists, doctors, and midwives increases the risk of unsafe deliveries and infections. Villages and hard-to-reach areas are often deprived of access to specialist doctors. In addition, the lack of transportation and ambulance services causes many patients to arrive at healthcare centers too late.”
Meanwhile, officials at the Ministry of Public Health of the Islamic Emirate say that 222 cases of maternal mortality were recorded at healthcare centers over the past year. According to them, the ministry is working to prevent an increase in maternal mortality by raising public awareness, expanding healthcare services, and improving mothers’ access to care, particularly in remote areas.
Sharafat Zaman Amarkhil, spokesperson for the Ministry of Public Health of the Islamic Emirate, says,
“Last year, 222 women died during childbirth at healthcare centers. Overall, this represents a decrease compared with previous years. We are working to prevent an increase in maternal deaths by raising public awareness and expanding healthcare services. However, more work is needed in this area. With the support of the international community and domestic funding, we have started efforts to address this problem.”
The findings of this report show that maternal mortality in Afghanistan is the result of a combination of interconnected challenges, including poverty, long distances, shortages of healthcare services, and delays in accessing treatment. As long as women—regardless of where they live or their economic situation—do not have access to safe and timely healthcare, pregnancy and childbirth will continue to represent not only the beginning of a new life for many families in Afghanistan but also, for some, a tragic ending.
Reporter: Soodaba Haidari
