Afghanistan Peace CampaignAfghanistan has the ninth-highest fertility rate in the world. It is an outlier in the region, its high birth rate similar to some of the countries in sub-Saharan Africa. However, under the Islamic Republic, the average number of children women were having was coming down, albeit with considerable variation by province, education and whether a woman lived in the city or countryside. High fertility is associated with early marriage, limited family planning and restrictions on women’s education and employment – all aspects of life under the Islamic Emirate. As there are no recent statistics on Afghanistan’s fertility rate, Kate Clark and the AAN team have been asking midwives and doctors around the country what they are seeing in their hospitals and clinics: Are Afghan women again having more children?
Afghanistan entered its fertility transition around the turn of the century. This is when child mortality falls, to be followed by a decline in fertility rates, as families begin to trust that their children will survive into adulthood. If family sizes are again increasing and that transition has gone into reverse, it would be highly unusual: declines in fertility tend to be ‘sticky’ because the education of women already in their childbearing years and preferences for smaller families do not reverse quickly. The consequences would be grave. Nearly half of the Afghan population is under 15 years of age, so the population is already set to increase by a third by 2040. Any increase in the fertility rate would build in even greater ‘population momentum’, as those children have children, with intensified pressure on the environment, economy and the push to migrate.
For Afghan women in particular, a rise in the fertility rate would be perilous: the risks of pregnancy increase markedly when mothers are adolescents or have multiple pregnancies back-to-back. The dangers would also be increasing in the wake of a deterioration in maternal healthcare over the last five years.
Most of the health professionals we heard from said they were seeing more teenagers, married and pregnant. Early marriage was being driven, they thought, by the barring of girls from high school and their having no future as women with professional jobs. Also important was acute economic need: the family gets a bride price from the groom’s when their daughter marries and, for some families, having one less mouth to feed also plays into their calculus.
The midwives and doctors also described the loss of autonomy for women who had become unemployed, making it more difficult for them to resist pressure from husbands, in-laws or wider society to have a big family. It is evident that, while Afghanistan did enter its fertility transition, small families never became the norm and strong pronatalist, patriarchal sentiments to have more children, especially sons, remain. Meanwhile, any choice by women/couples to space births or prevent pregnancies is undermined by how much weaker family planning provision has become, part of the general diminishment of health services under pressure from funding cuts by donors and Taliban budget choices.
Edited by Jelena Bjelica and Roxanna Shapour
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