Surviving Childbirth In Kabul

November 12, 2007 | By Paula Bronstein | News, Photography, Photojournalism

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Kabul, Afghanistan: I came to the Malalai hospital to shoot a story on surviving childbirth. The maternity facility delivers an average of 60-100 babies a day. In Afghanistan, one in nine Afghan women die during or shortly after pregnancy, which remains one of the highest mortality rates in the world for maternal mortality. In many cases, Afghan conservative cultural sensibilities put the health of the Afghan mother at risk.

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Ziajan, 35, was waiting on the operation table; she was almost full term and had a ruptured placenta along with heavy vaginal bleeding – every minute counted. The problem was her husband was not there to sign the consent form so the nurses just waited and started on another emergency case. In the mean time, Ziajan was in extreme pain. She was getting some blood to stabilize her until the cesarean operation could begin.

Ziajan’s case was truly heart breaking, the baby inside her womb was dead. He was to be her first son after having nine girls. Out of the nine, two had already died. In Afghan culture, having a male is extremely important and many women don’t have the choice but to keep trying until they are finally successful. Given Ziajan’s age and her health condition, this would have to be her last try. Knowing the Afghan culture like I do, I now understand why her husband was absent.

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About 45 minutes went by until the nurses could get going, I was told they got a signature from her brother. They started the c-section, the incision was made into her belly to bring out the fetus as I continued to photograph. All of a sudden the power went out and the room went dark. A few minutes passed but it seemed like ages. It was the second day of the big EID holiday, just after the end of the holy month of Ramadan so who knew how long it would take for someone to turn on the generator.

The surgeon was getting anxious and I knew this case was critical. I said to one nurse in Dari that I would be right back. I made the quick decision to go and grab a small key light I had in my photo bag. It was only a tiny light that I used to find things at night but it was all I had. I scrambled to find it in the dark but finally managed. I ran back and held the light over the pregnant woman’s belly. Immediately the operation team started up again using only my light. It was hard to keep it on since it was just one of those purse size ones that was made for short-time usage, once or twice it went off and the nurses started to please with me to try harder to keep it on.

Photographing was over for certain as I watched them bring out the lifeless baby boy. Finally the generator was cranked up and the lights came back on. Ziajan’s condition was still serious but the surgeon smiled a bit and turned to me saying, “tasha kor.” This means thank you in Dari.

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