A Matter of Life and Death: Afghanistan’s Maternal Healthcare Crisis
Despite the progress the Western world has made in healthcare, societal views, and medical technology, Afghanistan remains a striking contrast. According to the 2020 Human Development Report, Afghanistan ranked 169th on the Gender Inequality Index (GII), reflecting significant inequality in reproductive health, women’s empowerment, and economic activity. This inequality can have fatal consequences, particularly for Afghan women during pregnancy and childbirth. Afghanistan has one of the highest maternal mortality ratios in the world, with an estimated 636 maternal deaths per 100,000 live births. This means that pregnancy and childbirth remain a serious threat to the lives of Afghan women.
Afghanistan’s maternal mortality rate was already among the ten highest in the world before the Taliban returned to power. However, the crisis is not due to inadequate healthcare infrastructure alone. It is also connected to the systemic discrimination Afghan women face, particularly through restrictions on their education, employment, mobility, and access to healthcare. When women are prevented from freely accessing essential services, pregnancy and childbirth can become even more dangerous.
Under the current Taliban rule in Afghanistan, women face increasingly strict mahram requirements, which require them to be accompanied by a male guardian in certain public situations. These restrictions have expanded and become increasingly institutionalized, limiting women’s ability to travel, work, and access essential services. Taliban morality police have been used to enforce these regulations through street checkpoints and inspections of offices and facilities. Women who violate these restrictions can face harassment, intimidation, and physical punishment, while male relatives may also face consequences for failing to supervise them.
These restrictions can become especially dangerous when women need urgent medical attention. Reports have documented situations in which healthcare facilities have required women to arrive with a male chaperone, creating additional barriers for those seeking treatment. For pregnant women, these barriers can become matters of life and death. A woman experiencing complications during pregnancy or childbirth cannot always wait until a male relative is available to accompany her to a hospital. When access to emergency medical care is restricted, preventable complications can become fatal.
The problem is worsened by Afghanistan’s economic crisis. Following the Taliban’s takeover in 2021, the Afghan economy experienced severe instability, leaving many families in poverty and making healthcare even more difficult to afford. For women who already face restrictions on employment and financial independence, paying for transportation, medication, or medical treatment can create another barrier to receiving care.
Cultural and familial attitudes can further complicate the situation. Reports have described families who consider bringing a woman to a hospital shameful or who are uncomfortable with women being examined by male physicians. In a country where the number of female healthcare professionals is already limited, these attitudes can make it even more difficult for women to seek necessary treatment. The combination of institutional restrictions, economic hardship, and social expectations creates a healthcare system in which Afghan women can be left with very few options when they need medical care the most.
International organizations, including the United Nations and Doctors Without Borders, have attempted to address these issues and bring greater attention to the conditions facing Afghan women. However, the healthcare crisis has been further complicated by reductions in international assistance, including cuts to United States humanitarian aid. According to Refugees International, at least 161 preventable deaths among Afghan women and children have been linked to disruptions in healthcare and humanitarian assistance.
The reduction in funding has placed additional pressure on an already fragile healthcare system. More than 400 health facilities have reportedly closed, further limiting access to medical services in communities that already struggle with poverty and inadequate infrastructure. These closures are particularly concerning for pregnant women, who may need consistent prenatal care, emergency services, trained medical professionals, and access to hospitals during childbirth.
The shortage of female healthcare providers presents another significant challenge. In a society where cultural and religious restrictions can prevent women from being examined by male doctors, female healthcare workers are essential to ensuring women can receive appropriate medical treatment. Yet restrictions on women’s education and employment also make it increasingly difficult to train and maintain the female medical workforce needed to serve Afghan communities.
The future of healthcare access and maternal mortality in Afghanistan remains uncertain. As the Taliban continues to strengthen restrictions on women and international funding declines, Afghan women are being left increasingly vulnerable to preventable health complications. International humanitarian assistance is critical to keeping healthcare systems functioning, but aid alone cannot solve a crisis that is also rooted in restrictions on women’s freedom and access to care.
Afghanistan’s maternal mortality crisis is therefore more than a healthcare problem. It is a human rights issue. Women cannot have safe pregnancies and childbirth when they are prevented from freely reaching hospitals, obtaining medical care, receiving an education, or participating in the workforce. If Afghanistan is to reduce maternal mortality, women must be given meaningful access to healthcare and the freedom to seek that care when they need it. Without addressing the systemic barriers that prevent Afghan women from receiving medical treatment, preventable deaths will continue to be treated as inevitable when they are anything but.
