By Raha Azad
Women seeking tubal ligation have been turned away from a major hospital in Afghanistan, in the latest evidence that the Taliban are severely restricting all types of family planning in one of the world’s most dangerous countries to give birth.
Known colloquially as having your tubes tied, tubal ligation is a permanent sterilization procedure for women and has historically been popular in parts of Afghanistan where more accessible forms of contraception were unavailable, whether for cultural or economic reasons. Many women sought to have the procedure once they had the number of children they wanted.
But two medical workers at the central hospital in Faizabad, capital of the northeastern province of Badakhshan, told Rukhshana Media they had been told not to carry out the procedure. One, a doctor who has worked for about eight years in the gynaecology and obstetrics ward, said he had heard Taliban members telling the hospital staff to “let the Muslim generation grow”.
Three women said they had sought out the procedure and been denied it. All were poor, had endured difficult pregnancies in the past and said they struggled to feed the children they already had. One said she was told that to have the procedure was “a sin.”
Marzia, whose real name we are withholding for her protection, has eight children already. She had travelled for about 10 hours to reach Faizabad, along with a newborn and a toddler. When she told the doctors what she wanted, they told her she’d need written permission from authorities – something she knew she wouldn’t get.
“We don’t have enough food to eat, no work, no proper life. What should we do with so many children? They all grow up hungry, thirsty, and barefoot,” said the 36-year-old in despair as her baby cried beside her.
“I said (to the doctors) I don’t have the heart to give birth to more children. But the doctors said the Taliban have banned this operation. May God punish the Taliban, they are blind to the suffering of poor mothers like me.”
The remote mountainous area of Kiran wa Munjan, where Marzia is from, is poor and most women there still give birth at home, according to an earlier report by Rukhshana Media. Rates of maternal and neonatal deaths are high.
‘Extremely Worrying’
Tubal ligation is a safe surgical procedure that involves blocking the fallopian tubes so that the egg cannot meet the sperm, thus preventing pregnancy.
It was once a lifesaver for women like Qamar Gul, 35, who lives in Faizabad with her husband and six children. Times are hard, her husband is disabled, and she is desperate to avoid another pregnancy.
Three months ago, she went to the public hospital to have a permanent contraception surgery, but doctors told her the Taliban had banned it.
In another part of the city, a mother of five who earns a living by washing clothes and cleaning houses, said she wanted to have her tubes tied, but had been blocked.
“My youngest daughter is three months old. When I was close to giving birth, I went to the hospital and said I wanted the operation, so that the baby would be born and my tubes tied at the same time. But the doctors refused. They said this procedure is now illegal,” she said.
“I gave birth to these five children through immense hardship and medical treatment, risking my life. But now we have neither the economic ability nor the strength in my body have the strength.”
The doctor who spoke to Rukhshana Media said there was a clear need for the service, which appears to have been blocked or restricted in many parts of Afghanistan under the Taliban.
Under the previous government, a nationwide family planning programme was implemented to reduce maternal and neonatal mortality, encourage healthy spacing between births and prevent rapid repeated pregnancies. Public education campaigns and free distribution of contraceptives in some state health centres were part of this effort.
Rukhshana Media’s reporting suggests that the procedure may still be performed secretly in private clinics, but most women cannot afford the cost.
“When women are not allowed to make decisions about their own bodies, their physical and mental health problems multiply. We see repeated pregnancies without proper spacing endangering the health of mothers and newborns, and worsening the economic and social strain on families,” said the Faizabad doctor.
“Restrictions and women’s lack of access to contraceptives mean they cannot even use simple preventative or treatment methods. This situation is extremely worrying.”
