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A Midwife for Every Afghan Mother
Erica Barnett, 22 Aug 07

Afghani Mother and Child
Maternal mortality -- death due or related to childbirth or pregnancy -- is the leading cause of death among women in Afghanistan. The maternal death rate in Afghanistan is the second-highest in the world; only Sierra Leone's is higher. For every 100,000 women who go into labor in Afghanistan, about 1,900 die. According to UNICEF, one in nine women in Afghanistan will die during or shortly after pregnancy at some point in her lifetime. (By comparison, the maternal mortality rate in the US and Japan is eight per 100,000 births.) Infants whose mothers die in childbirth have only a one in four chance of surviving, so the high maternal death rate threatens women and children alike.

Most of these deaths are preventable, the product of unsanitary conditions, poorly maintained roads, limited access to health care, forced marriages, lack of education, poor nutrition and sanitation, and a fundamentalist religious regime that, even in the post-Taliban era, prohibits women from seeing a male doctor or health care practitioner and limits them largely to the home.

One glimmer of hope can be found in recent efforts to train hundreds of Afghan midwives. The presence of a midwife has been proven to reduce maternal mortality rates substantially -- one reason the World Health Organization has prioritized international midwife training in its goal of reducing maternal deaths by 75 percent worldwide in the next eight years as part of the United Nations’ Millennium Development Goals. Afghanistan has a long way to go; by some estimates, only 14 percent of Afghan births are attended by a skilled professional.

But the tide may be turning. In 2005, Afghan midwives banded together to form the Afghan Midwives Association; by 2006, the organization had been admitted to the International Confederation of Midwives, and had helped to triple the number of trained midwives in Afghanistan. Another program, known as International Midwife Assistance, focuses particularly on rural Afghan women who deliver their babies at home. In 2004, the Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO), an international health organization based in Baltimore, Maryland, launched its own training program for Afghani midwives. And earlier this year, the Swedish Committee for Afghanistan graduated a class of 20 midwives in the Wardak Province of Afghanistan. The goal of all these and other midwifery programs: To train women about healthy prenatal care and safe childbirth and parenting practices, including sanitation, proper diet, and care of newborn infants.

Two months from now, Family Care International will hold a global conference called Women Deliver in London, with the goal of saving and improving the lives of women, mothers, and infants worldwide. The ambitious-sounding conference will focus on maternal and newborn health, family planning, poverty reduction, freedom from violence, health system reform, building political will for women’s rights, and improving women’s political position in the world.


Image: flickr/chinapix

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Comments

So women were prohibited from seeing male doctors and so white-western organizations will accomodate that prejudice by training female midwifes?! Way to interfere with another nations cultural evolution! Maybe if they had been left to their own devices they might have re-evaulated their own cultural beliefs!


Posted by: The blog of David on 24 Aug 07

So women were prohibited from seeing male doctors and so white-western organizations will accomodate that prejudice by training female midwifes?! Way to interfere with another nations cultural evolution! Maybe if they had been left to their own devices they might have re-evaulated their own cultural beliefs!


Posted by: The blog of David on 24 Aug 07

You or your colleagues may be interested in knowing that ALL MY BABIES; A (Georgia USA) MIDWIFE'S OWN STORY, has just been released on DVD by IMAGE ENTERTAINMENT. Currently I am preparing a follow-up film which will assemble over a hundred mothers and their offspring who were helped by this midwife in Albany, Ga. where the original film was made. It will celebrate the work of traditional midwives and raise questions abouit the current alternative poor mothers must deal with in public hospitals. If films are included in your program I would like to know more.


Posted by: George C. St oney on 24 Aug 07

Excuse me but, as appaling as those statistics are, 1,900 out of 100,000 is NOT one in nine... it's more like 2 out of 100... please get your ratios right.


Posted by: Mel on 24 Aug 07

Mel:

You've confused the "per birth" ratio, 1900/100,000, with the lifetime ratio, 1/9. While a 1.9% mortality rate sounds small, if a woman gives birth to six children, her lifetime rate gets compounded to 10.9%, which is darn close to 1/9. This, of course, suggests that lowering infant mortality, so women don't give birth as often, may also reduce maternal deaths.

...appalling as those statistics are, they need to be explained a bit more clearly for folks who aren't biostatisticians. Even I had to think about those numbers a bit, and I teach this stuff! Good example for my students--thanks for raising the question.


Posted by: Michael Anderson on 25 Aug 07



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