Afghanistan has the second-highest maternal mortality rate in the world; a woman dies approximately every 30 minutes from causes related to pregnancy and childbirth. Also, one in five children dies during or after birth or before the age of five.
Some 2,400 midwives have been trained in Afghanistan since 2002. One of them is Mrs Rogul, who works in a village in Kabul province.
She has first-hand experience of consequences of giving birth without professional help. Her first eight children were born prematurely and they all died. The only help came from a woman with no medical training.
“She would ask my mum to do some strange things like shaking seven metal chains in a glass of water and then giving it to me so that my bleeding would stop,” Mrs Rogul recalled on the website for Save the Children, an international aid organisation.
Her ninth baby boy was born at term, but he died within the first 24 hours. After the delivery, the baby’s legs and arms turned green and he died. Now that Mrs Rogul is a trained midwife, she knows that he died from tetanus. That could have been prevented if Mrs Rogul would have received tetanus vaccine when she was pregnant.
Many babies in Afghanistan die because of ignorance and some traditional practices that hurt more than help. It is common to wash babies in very cold water immediately after birth, which can cause pneumonia, or babies are placed on a dirty floor to ward off evil spirits, which can cause infection. Also, use of an unsterilised knife or scissors, dirty fabric and unboiled water can cause infection.
After a baby is born, women don’t feed their infants with natural milk during the first few days because early milk that is believed to be dirty. Actually, this milk is very nutrious and vital for a baby’s immune system, but mothers feed newborns with melted butter, which doesn’t protect them from infections.
Mrs Rogul’s job as a community midwife is to make sure that women in her village know about harmful childbirth practices as well as healthy practices. She makes sure that women go to a health clinic for check-ups and that they know how to look after themselves and their children properly.
“A lot of people do things that are totally wrong due to lack of awareness,” Mrs Rogul told Save the Children. “Now they know what to do. Because of us community midwives, fewer mothers and babies are dying.”
The Ministry of Public Health is fighting against high maternal and infant mortality. The ministry’s programme aim to train and deploy 400 new midwives a year.
As a result of this, the number of women giving birth who were helped by a trained midwife has more than tripled since 2003. But as yet, there are not enough midwives in Afghanistan.
Luckily, Mrs Rogul received help in time and she now has three strong children. After she was trained to be a midwife, she has been able to help many other women deliver healthy children.