Pregnancy is a crucial phase for women, and external pressures can impact both the mother and child, causing physical and mental issues. The situation of pregnant women in Afghanistan is concerning due to factors like economic challenges, poor nutrition, limited healthcare access, and heightened pressures, posing significant risks.
The World Health Organization report highlights Afghanistan as having Asia’s highest maternal mortality rate. Many of these deaths, stemming from preventable causes, underscore the significance of women’s limited access to healthcare centres. This access gap has contributed to Afghanistan’s alarming maternal mortality rate.
Experts in obstetrics and gynaecology highlight that various factors, such as rising poverty and limited healthcare access, impact maternal and child well-being. However, they particularly underscore the psychological aspect of this matter. Their focus lies on the overlooked necessity for comprehensive care during pregnancy. They stress that the living environment must offer psychological security. In simpler terms, it should be free from any elements that could disturb the mental well-being of expectant mothers.
Dr. Saeeda Sediqi, a gynaecologist and obstetrician based in a private hospital in Kabul, emphasizes the significance of maternal mental well-being during pregnancy. She underscores that family violence experienced by pregnant women can result in premature birth. Dr. Sediqi says that deliveries occurring in households with violence frequently correlate with complications such as bleeding and inadequate infant care.
Ms. Sediqi highlights that postpartum psychosis is the predominant intentional mental issue of pregnant women. Women in this state struggle with interactive and social abilities, exhibiting involuntary behaviours like unexplained laughter and crying. Considering their real challenges, it is crucial to comprehend this condition to support mothers during and after pregnancy effectively
Ms. Sediqi also added that many mothers worldwide face the dire effects of “postpartum psychosis,” leading some to take their own lives. Additionally, a rarer yet more dangerous condition known as “Baby blue” affects pregnant mothers, occasionally harming their newborns, though such cases are extremely uncommon.
In Afghanistan, there is a lack of information regarding the emotional well-being of women and mothers both during and after pregnancy. Childbirth remains taboo, with doctors avoiding discussions in the media and mothers refraining from sharing their struggles and mental health issues. Consequently, women experience isolation throughout their pregnancy. Economic challenges and limited access to healthcare facilities further exacerbate this isolation.
Arzoo, a 35-year-old mother from Kabul with two children aged 13 and 8, is in her seventh week of pregnancy. She is worried about her family’s economic struggles and growingly concerned about her health, the baby’s well-being, and the upcoming delivery. Arzoo recalls giving birth to her previous two children in better circumstances, highlighting the contrast with the current living conditions. Throughout her seven-month pregnancy, she has only managed to see a doctor twice due to the challenging circumstances.
While poverty has impacted millions in Afghanistan, this pregnant woman underscores that giving expectant mothers greater attention and care can contribute to a healthier society. She says, “A healthy mother begets a healthy child and society.”
The United Nations Population Fund estimates that the inefficiency of Afghanistan’s economic crisis and health system might cause 51,000 maternal deaths during childbirth (2022-2025). Moreover, the health system’s shortcomings and lack of awareness increase infant mortality. A mother named Frishta, facing economic and psychological challenges, shared her painful story. Struggling with health issues and anxiety, she had to abort two pregnancies—her first ended in miscarriage due to health problems worsened by her condition. At the same time, the second was lost to stress and anxiety.
Frishta recalls, “During my sister’s time at Kabul University, an attack occurred while I was four months pregnant. Unable to reach her and consumed by worry, my health deteriorated, resulting in the loss of my child.”
Dr. Hawa Froutan, a specialist at a private hospital and professor at Kabul Institute, defines mental health as being calm in mind, psychology, and social interactions, leading to a comfortable life in society.
According to Ms. Froutan, our society’s social, economic, cultural, and family issues impact the mental well-being of pregnant mothers and their children. Increases in problems and concerns lead to a higher risk and a bad period for mothers.
Having a daily patient load of 15 to 20, she revealed that none are in sound mental states. The array of issues, like women’s restrictions and joblessness, has detrimentally impacted them. She emphasized that a mother must visit the doctor at least four times monthly during pregnancy to ensure her well-being.
Ms. Frouten says a direct link between a mother’s mental state and her baby’s condition. A positive maternal condition enhances the likelihood of a healthy baby, while the converse holds. Poor maternal mental health can result in various issues such as stunted nasal growth, cognitive disabilities, abortion, stillbirths, and future behavioural aggression in the child.
Mursal, who is seven months pregnant, shared that one of her children died three days after birth, and her older child struggles to walk due to weakness. Her husband had to immigrate because of economic problems and unemployment. Mursal is anxious about facing this difficult situation alone and expresses concern for her daughter’s well-being if things worsen.
Mursal, pregnant, expresses discomfort and physical pain. Following a doctor’s examination, both her and her child’s conditions are concerning. She struggles with sleep, avoiding actions that might harm her and the child.
In Afghanistan, women are the primary victims of domestic violence and the consequences of recent political changes.