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The inexperienced midwife killed my grandchild and put my daughter-in-law in critical condition

NOTE: This narrative contains language and details that may be disturbing to some readers. 

Afghanistan has one of the worst maternal death rates in the world, with one woman dying in childbirth every two hours. The situation is deteriorating as the Taliban restrict women’s access to healthcare, especially in rural areas, and it’s increasingly difficult for women to professionally train to be skilled women’s healthcare practitioners. 

Bakhtawara* told this story to a Zan Times journalist:

It was 2 a.m. in the morning. I was sleeping when my son came and said, “Gulnar* is in a lot of pain and is crying.” I hurriedly went to Gulnar. I could see that she was in labour and we needed to take her to hospital.

I told my son that we should find a car as soon as possible to take Gulnar to the hospital. In the hurry, I took a piece of clothes and cash with me. First, we went to the clinic near our house in Zihri district [in Kandahar province]. There were no medical staff there. We were told that the employees only work until 2 p.m. Then we drove to the city. After almost two hours, we reached the hospital.

I told the midwives that my daughter-in-law’s condition was not good and they should quickly help her. The midwife examined her with her hand and then told me, “The uterus has opened two centimetres; we have to wait for it to open to 10 centimetres.”

The midwife advised Gulnar to sit on both her legs to put pressure on her body. Four hours passed but Gulnar’s condition was getting worse. This had not happened to me when I had given birth and I understood that Gulnar was in a critical condition. I brought another midwife to see her. After she checked, she said, “The baby is upside-down, you need to apply more pressure to make it come down.”

It did not work. A midwife came to see Gulnar. She examined her with her hand. Then, even though she was repeatedly saying that Gulnar should put pressure on her body, she put her hands in Gulnar’s vagina and pulled the child’s legs down. The child moved. When it came out to the shoulder, the midwife took a pair of scissors and cut Gulnar’s vagina in several places.

Gulnar screamed. “Mother, I’m dying,” she cried. I got angry at the midwife: “How can she cut her body like that?” The midwife told me to leave the room. A few moments later, the midwife came out of the room and told me, “We didn’t realize that we had to first do a sonography examination. We found out that she has twins. We have to perform a caesarean for her other baby to be born.” At that moment, Gulnar’s first child was born. His body was bruised and he was not breathing. The doctors said that he would start breathing in a few minutes, but he was dead.

Because Gulnar’s vagina was torn, she was taken to the operating room. They told me, “You must find 200 cc of blood.” I had to tell my son to find blood to save Gulnar. We found the blood and bought all the medicine. Then they gave us a form that stated that the doctors and midwives of the Kandahar hospital are not responsible if, during the operation, the mother or child is in danger of death. We had to sign or apply a thumbprint to the document. After 20 minutes, the second child was born, but because of the stress of his birth, he was born with respiratory problems.

It is now three days since that awful night. Gulnar and her child are both in critical condition. Gulnar is bleeding a lot due to her injuries while her son remains in an incubator and continues to have difficulty breathing.

My biggest fear is that I will have to raise Gulnar’s twin girls if she dies. They are just 18 months old. Gulnar did not have a healthy break between her births but got pregnant early because of the need to have a son. 

My son is a poor farmer. It is difficult for him to pay the exorbitant expenses of Gulnar’s hospitalization, which didn’t happen before the Taliban came to power. Then, more experienced doctors worked in the hospital. Now they are inexperienced novices who are putting women’s lives in danger.

*Names have been changed to protect the identity of the interviewees and journalist.