The worst place in the world to give birth – exclusive pictures from Afghanistan

When the UN meets this week to discuss the Millennium Development Goals maternal mortality will be high on the agenda. The target to cut the rate by three quarters by 2015 is the most severely off-track of all the MDGs and every year half a million women are die in childbirth – most of them needlessly.

Afghanistan is one of the countries which is unlikely to meet the target. A woman dies there every 27 minutes thanks to pregnancy-related complications. There are 1,600 maternal deaths per 100,000 live births but in the remote mountainous province of Badakhshan the rate is 6,500 per 100,000 – the highest recorded rate of maternal mortality in the world.

Oxfam took top photojournalist Alix Fazzina to Badakhshan, where she met and photographed the families behind the statistics and the doctors, midwives and traditional birth attendants trying to save women’s lives.

The stories available include that of nineteen year old Harakat. Whilst she was heavily pregnant she endured a night of heavy bleeding before being taken to a clinic two hours away. When she arrived her blood pressure barely registered and the clinic realised there was little they could do. Harakat had to go to the nearest hospital, seven hours away, for an emergency caesarean section. After an hour of traveling Harakat gave birth in the car, and had to endure the rest of the journey with her dead baby girl still attached to her because they could find nothing to cut her away.

Harakat was stabilized at the hospital and was lucky to be alive.

“When I left my house I thought I would die,” she told Oxfam. Her daughter was buried in a nearby children's cemetery.

In Afghanistan:

• 25,000 women die every year
• Over 90% of deliveries take place at home and only 9% of deliveries are attended by skilled health personnel.
• Since 2002, over 2,000 formal midwives have been trained but Afghanistan requires another 8,000 to 10,000 midwives to reach its target of one midwife per 2,500-3,000 people.