‘Our Child Was Born in an Open Field’: U.S. Aid Cuts Deepen Afghanistan’s Maternal Health Crisis

This article was co-published with Zan Times.

In late March, Khatira*, a 23-year-old woman in her ninth month of pregnancy, died alongside her unborn child in the Afghan village of Gharibabad, Herat province — simply because there was no clinic left to help her. 

The local health center had shut down months earlier, in October 2024, after international funding was cut. The nearest medical facility lay in Herat, across a river that becomes swollen and impassable in the late winter and early spring months, severing Gharibabad's access. 

“I watched Khatira suffer in pain for a whole day,” Khatira's husband, Joma Khan*, said. “At midnight, I carried her on my back and, with immense difficulty, crossed the river. We were both submerged up to our chests.”

It took Khan more than 12 hours to reach Razaei Maternity Hospital in Herat. Without access to a car for the final leg of their journey, he and Khatira had to spend the night at a relative’s home. Come morning, they found the first available vehicle and rushed to the hospital, handing Khatira — wrapped in a blanket — over to the emergency unit.

Razaei is the largest maternity hospital in western Afghanistan, serving women from at least four provinces in the region. In 2022, the hospital reported an average of 2,500 natural births and 500 caesarean sections each month.

Five hours after arrival, doctors informed Khan that both his wife and their unborn child had died due to severe bleeding and prolonged labor. Khatira had suffered for 48 hours.

Her death has become a common story of maternal mortality under Taliban rule in Afghanistan, which advocates say is exacerbated in large part by the shuttering of international aid programming. Since U.S. President Donald Trump took office in January, the United States has cut nearly all of its promised $1.8 billion in aid to Afghanistan, according to a report released last week by the Afghanistan Analysts Network, significantly impacting humanitarian and basic services, particularly health. The United Nations has also scaled back its relief efforts, now targeting 12.5 million Afghans instead of 16.8 million, with UN officials warning the cuts will “directly result in deaths.”

The World Health Organization reports that nearly three million Afghans have lost access to healthcare due to the closure of 364 health centers since the beginning of this year. Another 220 are expected to shut down by the fall, meaning more than half of Afghanistan’s health facilities could be gone by year’s end.

According to local sources, the only operational clinic in Kushk Rabat Sangi district is in the district center, staffed by just one midwife. A healthcare worker at the clinic confirmed that the number of women coming for childbirth has increased significantly in recent months, with approximately 120 births now occurring there each month.

A senior doctor from the Herat provincial health department said the reduction in healthcare aid has impacted their operations: “Our healthcare workforce has been reduced, and many of the clinics supported by the World Health Organization have been shut down. We are witnessing the severe consequences of this situation in maternity wards.”

Several districts in Herat, including Kushk Kuhna and Kushk Rabat Sangi, have been affected by clinic closures, according to the same health official.

Homa*, a resident of Gharibabad, told More to Her Story she was forced to give birth outdoors due to blocked roads and the absence of a functioning nearby clinic. “We were heading to the clinic on a tractor, but Homa’s labor pains became unbearable, and we didn’t make it. Our child was born in an open field without any medical help,” said Homa’s husband, Faizullah.

At a press conference this week, UNFPA’s Andrew Saberton warned that a mother dies every two hours in Afghanistan from preventable pregnancy and childbirth complications. He said U.S. funding cuts have halted $102 million in UNFPA programs, leaving 6.3 million people — mostly women and children — without access to life-saving support.

Yet the impact of health clinic closures extends far beyond pregnant women. In July 2024, a five-year-old boy from Shirabad village died after drinking water contaminated with worms. His mother, Marzia, recounted how he began suffering from frequent nosebleeds, which she initially assumed were caused by heatstroke. After he fainted two weeks later, she rushed him to the district clinic, where doctors said his condition was critical and he needed urgent transfer to a hospital in Herat. “We headed toward the city, but he died on the way,” she told More to Her Story.

Safiullah, the village elder of Pain Deh in Kushk Rabat Sangi district, has observed a troubling rise in preventable deaths, noting that in the northeastern part of the district, home to about 120 villages, no functioning health centers remain. “In the past year, I’ve witnessed the deaths of three pregnant women and eight children between the ages of six months and seven years in nearby villages. Many families simply cannot get their sick to a health center or to Herat city in time,” he said.

The Taliban’s Ministry of Public Health did not respond to More to Her Story’s questions about the total healthcare budget required to keep services running, their emergency health priorities, or any proposed plan to address the growing healthcare crisis.

With more than half of Afghanistan’s health centers expected to close by year’s end, millions of Afghan women and children are being left to face life-threatening complications, alone.

*Names have been changed for safety.