Pregnancy and delivery deadly for many Afghan women

Researcher to present findings on September 11

Wednesday, September 11, 2002

A researcher at Brigham and Women's Hospital (BWH), who has studied women's health and human rights in Afghanistan as part of her work with Physicians for Human Rights, has found that primitive and scarce medical care makes the region one of the most dangerous places in the world for a woman to experience childbirth.

Lynn Amowitz, MD, MSPH, MSc of BWH, will present her findings -- which are published in the September 11 edition of the Journal of the American Medical Association -- at BWH from 12 - 1 PM, at the Carrie Hall conference room. The presentation will explore how human rights issues impact maternal mortality and the quality of healthcare Afghan women receive.

Amowitz found that women in the Herat province of Afghanistan receive some of the most inferior maternal healthcare in the world. Many clinics in the province lacked the basic medical supplies necessary for healthy delivery, such as forceps and intravenous antibiotics. Additionally the availability of Afghan doctors in the province providing pre- and post-natal care had decreased to alarming levels.

"We went village to village, and what we found was a woefully inadequate level of healthcare options for women, if any," said Amowitz. "In rural areas, a woman's chance of dying because of complications with her pregnancy is far greater than in urban areas. That's abysmal."

Most care is symptom-based, said Amowitz. In her study, which was funded by Physicians for Human Rights, she concluded that most Afghan women in Herat only seek-out medical treatment once they encounter serious complications with their pregnancy and may not be able to get to an adequate facility in time, or have the money to afford care. Very few women, Amowitz found, had access to doctors, midwives or trained birth attendants who could provide regular check-ups that would reveal abnormalities early-on, while they're still treatable, or handle complicated pregnancies if needed. The study also determined that only 11 percent of the 5000 women surveyed received any kind of prenatal care.

Researchers also determined that many Afghan women in Herat are having multiple babies in their adolescence, even though their own bodies are malnourished and not fully matured. Because women start child-bearing at an early age, the risk of death these women experience from childbirth significantly increases each time a woman has a baby, said Amowitz.

"This study underscores the idea that there is a very distinct correlation between basic human rights and healthcare," said Amowitz. "The painful irony is that expectant mothers in Herat often must give their own lives in order to give life to someone else."

BWH is a 716-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare System, an integrated health care delivery network. Internationally recognized as a leading academic health care institution, BWH is committed to excellence in patient care, medical research, and the training and education of health care professionals. The hospital’s preeminence in all aspects of clinical care is coupled with its strength in medical research. A leading recipient of research grants from the National Institutes of Health, BWH conducts internationally acclaimed clinical, basic and epidemiological studies.

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