Raising Awareness: USAID’s Promote: Jawana Participants Organize Maternal Health Sessions in KabulAt the age of 38, Tarina is already a mother of 12 children. Numerous pregnancies have taken their toll. The fatigue is the worst, she says—that and the incontinence and chronic pain from injuries sustained during these childbirths.

“This life is worse than death for me,” Tarina says, adding, “but what would happen to my children?”

Until a week ago, Tarina and her husband had never even heard of modern contraceptive methods—or indeed, that it was even possible to avoid a pregnancy altogether.

Thanks to a workshop pulled together in 3 months by six USAID’s Promote: Women’s Leadership and Development (WLD) Jawana participants, Tarina now knows that not only is repeated childbearing harmful to both mother and child, but that she and her husband can prevent repeated pregnancies.

The workshop disseminated information about birth spacing, contraception, the risks of too many children, the perils of giving birth too early and too late and the importance of vitamin supplements and nursing throughout the pregnancy to 200 women in Kabul’s Bagh-e-Zanana neighborhood.

USAID’s Promote: Jawana team leader Madina Habib came up with the idea after hearing her sister shared with her the suffering, trauma and premature deaths that she witnesses daily as a midwife. “I have always wanted to try and help solve this problem,” Madina explains and adds, “I am privileged to play a positive role to help reduce deaths of mothers who die because they don’t have the knowledge or means to space their pregnancies or to control the number of children they give birth to.”

Even though maternal mortality rates in Afghanistan have declined in recent years, the World Bank statistics reveal that in 2015, more than 396 Afghan women lost their lives for every 100,000 live births—compared to 7 in Canada and 3 in Finland.[1] The majority of maternal deaths result from a combination of early and frequent childbearing, inadequate birth spacing, poor nutrition, and lack of access to emergency obstetric care.

Partnering with the Afghan Family Guidance Association (AFGA), USAID’s Promote: Jawana team is working with local obstetricians to inform Afghan women about inexpensive and effective family planning methods. In addition to providing important logistical support, AFGA assists in distributing important pregnancy supplements like the folic acid—a supplement necessary to maintain maternal health.

“We have made a mistake,” Tarina told the audience. “Please be careful not to have such a big family like ours. I cannot pay enough attention to any of my children—because of suffering from illnesses and the terrible consequences of giving birth to so many children,” she added.

Madina was very satisfied with the workshop that USAID’s Promote: Jawana members recently organized but acknowledged that still there is so much more to be done! “I know this small workshop is not sufficient,” she asserted - “More people, including men, need to be aware. I am going to try and do my utmost to find more resources and expand this much-needed workshop beyond my neighborhood.''