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Giving Birth to Progress

Authors: Isobel Coleman, Senior Fellow and Director of the Civil Society, Markets, and Democracy Initiative; Director of the Women and Foreign Policy Program, and Gayle Tzemach Lemmon, Senior Fellow for Women and Foreign Policy
Fall 2011
Ms. Magazine


In a sparse but neat classroom with plain white walls and a cement floor, a group of young Afghan women wearing crisp blue medical uniforms and dark headscarves stands at attention. They are midwives in training in central Afghanistan. Soon, they will be deployed to the front lines of the country's fight against the world's worst maternal-mortality statistics. It is a battle they are waging slowly, one pregnant woman at a time. But the students say they see signs of progress—and they are eager to be part of it.

"In my district the hospital is very far, sometimes five to seven hours even by car, and I know a lot of women who have died during pregnancy," says Salima, a bright-eyed student whose headscarf hangs loosely around her face. "People are very happy the midwives are there now, because the ability of women to access prenatal care was very low, and that is why I am going to help."

Even in Afghanistan's cities, where distances are less daunting, a lack of basic health infrastructure and widespread poverty mean that maternal mortality and access to emergency obstetric and neonatal care remain a challenge. In 2002, after 30 years of war and the brutal Taliban regime, the country was a shambles with a broken health system. There were just 467 midwives in the entire country. One out of 7 women was likely to die in childbirth, compared with 1 out of 3,500 in the United States.

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