Bring a mahram or die: The Taliban threat to expectant mothers
As Zarin Gul and her daughter Nasrin ventured through the village of Yangi Areeq, the only light came from the small lamps of their rickshaw. Nasrin was writhing and groaning in the pain of labour, which was intensified by the constant jolts of the rickshaw on the dirt road. Zarin Gul was growing more anxious with every passing moment.
“I kept thinking, if only Nasrin’s husband were here. If only I could ease my daughter’s pain,” Zarin Gul tells Zan Times. Nasrin’s husband had been working in Iran for the past seven years and only returned home one month a year.
That night, Zarin Gul held her daughter’s hands, trying to comfort her. During their journey to the hospital, a Taliban fighter signaled them to stop with a flashlight. “Where are you going?” he asked.
As a frightened Zarin Gul loudly explained that her daughter was sick and needed urgent medical attention, one of the three Taliban fighters standing there ignored her distress and instead asked, “Where is your mahram?” They didn’t have one.
Again, Zarin Gul explained that her daughter’s condition was critical and that her husband was in Iran, but the Taliban fighters were firm: “You must bring a mahram. Otherwise, we will not allow you to go to the hospital.”
“I begged them, telling them my daughter was dying. I pleaded for their permission,” she recalls. “But they still refused. In desperation, I lied and said the rickshaw driver was my nephew and our guardian. Only then did they let us pass.”
After that encounter at a Taliban checkpoint, Zarin Gul managed to get her daughter to a private hospital. But it was too late. Nasrin’s baby had already died in her womb, and her uterus had ruptured. The doctors warned that her life was in danger and she needed to be immediately transferred to a government hospital. So the 62-year-old mother set out once again with her suffering daughter, this time toward a government hospital an hour away.
Zarin Gul never imagined that her daughter’s eighth childbirth would turn into a matter of life and death. When her daughter first started feeling pain, she had taken her to a midwife, who gave her an artificial labour-inducing injection. Instead of helping, it only worsened Nasrin’s bleeding.
Zarin Gul explains that the midwife lacked proper training and had been appointed to the local clinic due to her Taliban connections: “She used to administer polio vaccines to children, nothing more. But with influence, she became a midwife, and now women in the area have no choice but to seek her help.”
On their way to the government hospital, mother and daughter were stopped at two more Taliban checkpoints. Each time, they were detained for long periods because they lacked a male guardian. Zarin Gul says they were only allowed to pass through the second checkpoint after she cried and begged. But at the third checkpoint, even her tears and pleading had no effect: “In the end, the rickshaw driver had to leave his identification documents as a guarantee before they let us go.”
After repeated obstacles, Zarin Gul finally reached the government hospital — but the delays had proved deadly.
“The doctors told us that due to excessive bleeding and the ruptured uterus, both the baby and the mother had died,” she tells Zan Times. S. “They performed a C-section on my daughter after she had already passed away. What was the point? We buried them side by side.”
The Taliban’s policy requiring a male guardian for women in labour wanting to reach health facilities, combined with limited access to healthcare, unsafe roads, and a culture that neglects women’s health, has significantly increased maternal deaths in Afghanistan. Many women lose their lives because of these restrictions. Nasrin’s seven children are now growing up without their mother.
This report on the impact of the Taliban’s rigid policies on women in childbirth is based on interviews with 27 healthcare workers, 14 postpartum women, and three families who lost their loved ones during childbirth from provinces including Helmand, Kandahar, Nangarhar, Parwan, Kapisa, Panjshir, Ghazni, Takhar, Jawzjan, Samangan, Faryab, Badakhshan, Baghlan, Herat, and Kabul. Hospital staff tell Zan Times that female patients and doctors are prohibited from entering healthcare facilities without a mahram due to orders from the Taliban’s Ministry for the Propagation of Virtue and Prevention of Vice.
Interviews with women and their families reveal that due to the Taliban’s rigid policies, many skilled female doctors have resigned, leaving untrained and inexperienced personnel to take their places in hospitals. Zan Times is seeing the impact of those Taliban decisions through on-the-ground reporting inside Afghanistan. Our team regularly speaks with medical personnel, hospital officials, and women needing healthcare. Consistently, they report that the system is collapsing — female medical professionals are being pushed out, and maternal deaths are increasing.
In early February, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) reported that approximately 600 women die for every 100,000 births in Afghanistan, a maternal mortality rate three times higher than the global average. While that statistic is from 2020, it is still used because no comprehensive updates have since been published. Other reports highlight the increasingly precarious situation facing women in childbirth. In 2023, an academic survey of Afghan healthcare workers revealed that more than 40 percent reported a decrease in maternal and child healthcare availability while 26 percent saw an increase in obstetric and newborn complications. In 2024, UN Women projected that the impact of keeping girls out of school and women out of university would correlate with a 45 percent increase in early childbearing rates and a 50 percent increased risk of maternal mortality. In addition, the recent OCHR report stated that the country’s long-term public health system is further threatened by the Taliban’s decision in early December 2024 to close all medical educational institutions to women, including semi-professional courses.
The growing shortage of qualified medical professionals and midwives has put the lives of women and children at serious risk, particularly in rural areas. In these regions where few trained doctors are available, women and children lack timely access to proper medical treatment. As a result, many women die from preventable and treatable conditions, including childbirth complications.
If that weren’t enough, expectant mothers are also struggling to feed themselves with nutritional food. OCHA has warned that this year an estimated 22.9 million people in Afghanistan will require humanitarian aid, with 14.8 million — more than a third of the population — facing severe food insecurity. The report further highlighted that 1.1 million women require urgent medical care.
Samina*, a midwife working in a government hospital in Kandahar, tells Zan Times that there is not enough medical staff at her hospital to treat the more than 100 women who seek medical care each day. She confirms that women will only be admitted if they are accompanied by a male mahram.
Speaking to Zan Times, Samina recounts an incident from a few days earlier: “A young woman arrived at the hospital after giving birth in a taxi. Her baby had died on the way due to a lack of oxygen. When I asked her why she hadn’t come to the hospital sooner, she replied, ‘I had to wait for my husband to return from work. I had no other male guardian.’”
Another reliable source from Mirwais Regional Hospital, a major government hospital in Kandahar, tells Zan Times that 250 women come in for childbirth every 24 hours. “This hospital receives patients not only from Kandahar but also from Zabul and Uruzgan. Most arrive in critical condition, and some die simply because they were brought in too late. Some babies die in the womb, while others pass away within minutes of birth,” the source explains, noting that, for the year ending in February 2025, the hospital recorded at least 800 maternal deaths and more than 1,000 newborn deaths.
The source also confirms that the Taliban’s Ministry for the Propagation of Virtue and Prevention of Vice has strictly ordered hospitals not to admit women without a male guardian: “Every morning, we inform patients that coming to the hospital without a male guardian is prohibited. This rule is strictly enforced by the Taliban, and no one dares to defy it.”
When 26-year-old Zamarrud, a resident of Kishm district in Badakhshan, went into labour five months ago, her husband was in Iran. Soon after the labour pains began, her water broke, indicating a possible ruptured amniotic sac. But there was no man in the house to take her to the hospital. Her mother-in-law and sister-in-law decided to take her on foot. “I felt dizzy on the way, and I couldn’t walk. My mother-in-law and sister-in-law had to hold me up and drag me along,” Zamarrud recounts to Zan Times.
After a two-hour walk, the exhausted and pain-ravaged woman finally arrived at the hospital — only to be denied entry because she had no mahram. She waited outside, pleading for help, for 40 minutes, before being allowed inside.
Doctors immediately took her to the emergency room, but her baby was already dead.
“My baby was gone. Carrying a child for nine long months and then not being able to hold them in your arms — it feels like dying,” she says.
Due to a shortage of unoccupied beds in the hospital, Zamarrud was discharged just a few hours after childbirth. With no strength to walk, her mother-in-law placed her on a donkey. The journey along rough, winding roads worsened her postpartum wounds.
“My stitches started bleeding, but I had no choice but to continue. By the time I got home, I was half dead. And once there, I had nothing but painkillers to rely on,” she recalls.
Since returning to power in 2021, the Taliban have stripped Afghan women of nearly all their rights — banning them from education, work, travel, leisure, and even public baths. Their policies have also discouraged the few remaining female healthcare professionals from continuing their work, further deteriorating an already fragile healthcare system. A midwife from Takhar province says that officials from the Taliban’s Ministry for the Propagation of Virtue and Prevention of Vice constantly harass and humiliate female medical staff: “We try our best to do our jobs, but the pressure is unbearable. Many of us just want to quit. Sometimes, they insult us, claiming our clothing is ‘un-Islamic.’ But women who are the sole providers for their families have no choice but to stay.”
She also describes shocking instances of Taliban interference in emergency situations: “One day, our emergency ward was overwhelmed with patients. That section is for women only, and men are not allowed. But Taliban enforcers barged in and took away three female nurses, claiming their uniforms were inappropriate. They made them sign a pledge to wear longer clothing before letting them go.”
She struggles to explain the cruelty of the Taliban: “Even in life-and-death emergencies, instead of letting doctors treat patients, they arrest female staff over their clothing.”
*Names have been changed to protect the identity of the interviewees and writer. Sana Atif is a pseudonym for a Zan Times journalist in Afghanistan.
This report was produced with contributions from Mahtab Safi, Atia FarAzar, Khadija Haidary and Hura Omar.
