Afghan woman to use ARMC Midwifery Practice as a model for her own clinics

Pashtoon Azfar's path was laid out for her when she was about 10 years old. That was the first time she acted as an unofficial midwife for her own mother in Afghanistan, a country where most women give birth at home.

Now, Azfar is president of the Afghan Midwives Association and is widely regarded as Afghanistan's great hope for reversing the country's maternal mortality rate, the second highest in the world. About 1,800 women in Afghanistan die per 100,000 births, mostly from hemorrhaging and obstructed labor, according to UNICEF. That number is even higher in rural parts of the country.

This month, Azfar traveled from Kabul to Athens to spend a week at the Athens Regional Medical Center's Midwifery Practice, which has assumed an important role in her work. The Athens practice will serve as the model for at least two new midwifery clinics in Afghanistan.

"Pashtoon is such a pioneer," said Susan Fisher, director of the Midwifery Practice, on the last day of Azfar's visit. "It's such an honor to be in her presence. Midwives in Afghanistan look up to her ... she's the Mary Breckinridge of Afghanistan," she added, referencing America's leading historic figure in midwifery.

Last year, the New York Times profiled Azfar following her appearance at a Capitol Hill briefing on maternal health in Afghanistan. In addition to other appointments, the mother of five acts as director of Afghanistan's Institute of Health Sciences; she visited Athens with members of the World Health Organization Collaborating Center for Reproductive Health at the Centers for Disease Control and Prevention.

"She's a tireless advocate for women," Fisher said. "She's so inspirational. We're star-struck she's here."

Of ARMC's Midwifery Practice, "I found it excellent, excellent, excellent," Azfar said during an interview at the end of her week here.

Azfar was especially impressed with the centering sessions for parents, a program that was started a year and a half ago to bring mothers- and fathers-to-be together in regular group meetings. She wants to replicate it, she said, but not with the mother-father model, which would be "culturally not acceptable," she said. Instead, it'd be with mothers and mothers, or mothers and sisters, or - most likely - mothers and mothers-in-law.

In Afghanistan, "The role of the pregnant mother is too weak," Azfar says. One must advise the "decision-maker" - not the mother-to-be-during the pregnancy. Knowing this, Azfar has developed the skill of convincing relatives to guide the mother to the right choices. She often is able to pers

Comment on "Afghan woman to use ARMC Midwifery Practice as a model for her own clinics"