Building Safer Births Through Afghan Midwives

Every safe delivery depends on knowledge, preparation and timely support. In Afghanistan, midwives have long served as a vital bridge between families and the health system, particularly in rural areas where hospitals may be distant and transportation difficult. Their work reaches beyond the delivery room: they provide antenatal care, identify warning signs, explain healthy practices and help mothers seek urgent assistance.

Training strengthens that role. When Afghan midwives receive practical instruction, mentoring and access to reliable clinical guidance, they are better prepared to manage childbirth complications and protect newborns during the first critical hours of life. Their presence can make skilled birth attendance possible for women who might otherwise deliver without professional care.

The UN70 “Strong UN. Strong Afghanistan.” campaign presented stories of Afghan people whose service helped build stronger communities. Although the campaign website is now an archived snapshot, its focus on local contribution remains relevant. The experience of midwives shows how investment in Afghan professionals can support healthier families and more resilient communities.

Why Skilled Midwives Matter

Pregnancy and childbirth can change quickly. A mother who appears well may develop severe bleeding, high blood pressure, infection or obstructed labour. A newborn may struggle to breathe or require immediate warmth and resuscitation. A trained midwife is equipped to recognize these dangers, begin essential care and arrange referral when advanced treatment is needed.

Midwives also help women before labour begins. During antenatal visits, they can monitor the mother’s health, discuss nutrition and birth preparedness, encourage vaccinations where appropriate and explain symptoms that require urgent attention. These conversations give families a clearer plan and reduce the chance that warning signs will be ignored.

The value of a midwife is measured in trust as well as clinical skill. Women may feel more comfortable discussing pregnancy concerns with a familiar female health worker who understands local language, customs and household realities. Respectful care can encourage mothers to attend check-ups, deliver with a skilled provider and return for postnatal support.

Training Designed For Real Conditions

Effective UN-supported health training must reflect the conditions in which Afghan midwives work. A course based only on theory cannot prepare a provider for a remote clinic with limited electricity, scarce supplies or a long referral journey. Practical sessions therefore need to cover assessment, infection prevention, emergency procedures, newborn care and communication with families.

Simulation can help midwives rehearse urgent decisions before they face them in practice. Repeated exercises on managing postpartum haemorrhage, eclampsia, prolonged labour and newborn breathing difficulties can build confidence and improve teamwork. Training is strongest when it is followed by supervision, feedback and opportunities to refresh skills.

Continuity matters as much as the initial lesson. Clinical recommendations change, providers move between facilities and difficult cases can expose gaps in knowledge. Refresher courses, peer learning and supportive supervision help turn a single training event into lasting professional development. They also give midwives a space to share local solutions and raise problems that require broader health-system action.

From Training Room To Delivery Room

The impact of maternal health training depends on whether midwives can use their skills when a mother needs them. A provider may know how to stabilize a patient, yet lack medicines, sterile equipment, blood supplies, transport or a functioning referral network. Safer childbirth therefore requires a combination of trained personnel, prepared facilities and dependable links between community care and hospitals.

Birth preparedness is one practical part of that system. Midwives can help families identify a preferred place of delivery, estimate travel time, save emergency contact details and consider transport arrangements. These plans are especially important where roads, weather or insecurity can delay a referral. Early communication with a higher-level facility may allow clinicians to prepare before the mother arrives.

Records and communication are equally important. Clear notes about antenatal findings, labour progress, medications and referral reasons help the next provider act quickly. Simple reporting systems can also show health authorities where complications are occurring and where additional staff, equipment or outreach services are needed.

Comparing The Building Blocks Of Safer Care

Maternal health does not improve through training alone. Each part of the care pathway supports the others, from the first pregnancy visit to emergency referral and postnatal follow-up. The following framework shows how different measures contribute to safer childbirth.

Care component	What it provides	How midwives contribute	What strengthens the result
Antenatal care	Early detection of health risks and pregnancy complications	Assess mothers, give guidance and arrange follow-up	Regular visits, basic equipment and accurate records
Skilled birth attendance	Monitoring during labour and immediate response to danger signs	Conduct deliveries safely and begin emergency care	Competency-based training, supplies and clean facilities
Newborn care	Support with breathing, warmth, feeding and infection prevention	Assess the baby and teach families essential practices	Resuscitation equipment, supervision and referral access
Emergency referral	Transfer to a facility with more advanced treatment	Recognize when local care is insufficient and coordinate transport	Reliable communication, transport and prepared receiving hospitals
Postnatal support	Follow-up for mother and child after delivery	Check recovery, breastfeeding and warning signs	Home visits, community outreach and accessible clinics

This approach also clarifies why investment in one area should not be separated from the others. A well-trained midwife needs an enabling environment, while a well-equipped clinic needs competent staff. Strong partnerships can align professional education, supplies, facility improvements and community engagement around the same goal.

The principle applies across public services. The UN’s work with rural Afghan teachers illustrates how locally rooted professionals can extend essential services beyond major urban centres. Midwives play a comparable role in health: they carry specialized knowledge into communities where distance and limited resources can otherwise determine who receives care.

Trust, Culture And Women’s Health

Technical expertise becomes more effective when women feel safe using the service. Midwives can create that safety by protecting privacy, seeking informed consent, listening without judgment and explaining procedures in understandable terms. Respectful maternity care is not an optional addition to clinical quality; it influences whether families return for care and recommend a facility to others.

Community engagement can address concerns before they become barriers. Meetings with elders, women’s groups, religious leaders and families may help explain the importance of antenatal visits, skilled delivery and emergency referral. These discussions should present communities as partners rather than passive recipients. Local knowledge can reveal the practical reasons women postpone care, including cost, transport, household responsibilities or fear of mistreatment.

Women’s health also requires attention after birth. Midwives can support breastfeeding, discuss birth spacing, screen for signs of infection and encourage follow-up for both mother and baby. They may also identify mental health concerns or signs that a woman needs additional social support. A continuous relationship is more protective than a single encounter at delivery.

Partnership Behind The Professional

Training programmes are most sustainable when they connect Afghan institutions, health workers, communities and international partners. The United Nations and its agencies can contribute technical guidance, coordination, resources and support for national health priorities. Afghan ministries, training institutions and local health organizations provide essential leadership and knowledge of the country’s needs.

Partnership should also include the people who deliver care every day. Midwives can identify which training methods are practical, which supplies are missing and which referral arrangements fail in real situations. Their experience can improve programme design and prevent resources from being directed toward solutions that look effective on paper but are difficult to use in a remote clinic.

Data helps partnerships remain accountable. Monitoring the availability of skilled birth attendants, antenatal coverage, referrals, essential medicines and maternal or newborn outcomes can show where progress is being made and where action is still needed. Data collection must protect privacy and avoid reducing women’s experiences to numbers, but reliable information is necessary for sound decisions.

The UN70 campaign’s message, “Strong UN. Strong Afghanistan.”, placed emphasis on shared responsibility and Afghan achievement. Midwives embody that idea through daily service. Their expertise is strengthened by international cooperation, yet the care itself is delivered through relationships with Afghan mothers, babies and communities.

Priorities For Safer Childbirth

• Expand competency-based midwifery education with supervised clinical practice and regular refresher training.
• Ensure health facilities have essential medicines, clean water, infection-control materials and equipment for newborn resuscitation.
• Build dependable referral systems with working communication channels, transport plans and prepared receiving hospitals.
• Support respectful, confidential maternity care that responds to women’s language, culture, privacy and informed choices.
• Use community outreach and health data to identify underserved areas and direct resources where they can save the most lives.

These priorities work best when planned together. Training without equipment can leave providers unable to act, while supplies without skilled staff may remain unused. Similarly, a referral policy has limited value if families cannot reach a facility or if the receiving hospital is not informed in time.

Investment in midwives should therefore be viewed as investment in the wider health system. It supports women during pregnancy, protects newborns, strengthens primary care and creates a trusted connection between households and professional services. It can also provide Afghan women with meaningful careers and leadership opportunities in their own communities.

The archived UN Afghanistan campaign remains a record of a completed public information effort, but the values it highlighted continue to matter. Recognizing Afghan midwives means recognizing the training, courage and local commitment required to make childbirth safer. Supporting their work through sound policy, sustained funding and community partnership can help more mothers and babies receive skilled care when it matters most.

Organizations, health professionals and community partners can carry this work forward by supporting midwifery education, strengthening rural clinics and promoting respectful maternity services. Every trained provider, prepared facility and informed family adds resilience to Afghanistan’s health system and brings safer childbirth within reach of more communities.