It was the middle of the night when Zarin Gul realised that her daughter Nasrin had to get to the hospital as soon as possible. Her daughter’s husband was away working in Iran and the two women were alone with Nasrin’s seven children when Nasrin, heavily pregnant with her eighth child, began experiencing severe pains.

Gul helped Nasrin into a rickshaw and they set off into the night. Holding her daughter’s hand as the rickshaw jolted over the dirt road, Gul says she prayed they would not encounter a Taliban checkpoint.

“I kept thinking, if only Nasrin’s husband were here. If only I could ease my daughter’s pain,” she says. Her prayers were not answered. The rickshaw’s small lamp was spotted by Taliban fighters who signalled for them to stop and demanded to know where they were going.

“I begged them, telling them my daughter was dying. I pleaded for their permission,” says Gul. “But they still refused. In desperation, I lied and said the rickshaw driver was my nephew and our guardian. Only then did they let us pass.”

By the time they reached the hospital it was too late. Nasrin’s baby had already died in her womb, and her uterus had ruptured. The doctors said Nasrin needed to be transferred to another hospital and so Gul helped her daughter into another rickshaw and they set off again, towards a government hospital an hour away. On their way they were stopped at two more Taliban checkpoints, each time detained for long periods because they were travelling alone.

They did finally reach the hospital, but Nasrin had not survived the journey. “The doctors told us that due to excessive bleeding and the ruptured uterus, both the baby and the mother had died,” says Gul. “We buried them side by side.”

The Guardian and Zan Times, an Afghan news agency, has interviewed dozens of women and healthcare professionals across multiple Afghan provinces. Their testimonies build a picture of a maternal and child healthcare system dangerously compromised and eroded by the Taliban’s draconian policies towards women.

Even before the Taliban took power, Afghanistan had a maternal mortality rate three times higher than the global average, according to the last official World Bank figures from 2020.

Experts warn that maternal health is likely to deteriorate further, compounded by the Taliban’s decision in December 2024 to close all medical training to women, including prospective midwives.

According to a report by the World Health Organization (WHO), 24 mothers and 167 infants already die every day in Afghanistan from preventable causes. It is estimated that more than 20,000 villages across the country lack basic healthcare services, affecting 14 million people.

A recent UN Women report estimated that by 2026, a woman’s chance of dying in childbirth will have increased by 50%.

A medical professional at Mirwais regional hospital in Kandahar says the hospital receives female patients from across Kandahar but also from neighbouring provinces.

“Most arrive in critical condition and some die simply because they were brought in too late,” they say. “Some babies die in the womb, while others pass away within minutes of birth.” According to staff, the hospital recorded at least 800 maternal deaths and more than 1,000 newborn deaths last year.

“A young woman arrived at the hospital after giving birth in a taxi,” says Samina, a midwife working in a government hospital in Kandahar. “Her baby had died on the way due to a lack of oxygen. When I asked her why she hadn’t come to the hospital sooner, she replied, ‘I had to wait for my husband to return from work. I had no other male guardian.’”

Two women told the Guardian they had experienced miscarriage due to inability to access care. One interviewee reported the death of a family member during labour.

“My sister died yesterday during childbirth,” says 35-year-old Pashtana* from Kandahar province. “Her husband was not at home when she went into labour, and she could not go to the doctor alone.”

Pashtana said if her sister had travelled to the clinic alone, “she would not be treated because she did not have a mahram”.

Several women told the Guardian that they were denied treatment and prescriptions in the absence of a male guardian or because they lacked the permission of one.

“I don’t get to see the doctors or get medicines unless I am accompanied by my son or grandson,” says Qandi Gul*, a 50-year-old woman who had travelled to a clinic for an eye exam.

A female doctor from the eastern province of Nangarhar says: “Since the Taliban takeover, women don’t visit the doctor unless the sickness develops to the point of being unbearable.

Already, a growing shortage of qualified medical professionals and midwives is putting the lives of women and children at serious risk, particularly in rural areas where few trained doctors are available.

Doctors interviewed by the Guardian estimated that “more than half” of their female colleagues had quit their jobs, particularly in smaller cities and villages.

“Most of my colleagues have left Afghanistan and this has severely affected the healthcare sector in the country,” said Dr Sima*, who chose to stay along with her husband, also a doctor. “We are both specialists, and we realised we would not be able to do this work abroad so we stayed to serve the country.”

A midwife from Takhar province says officials from the Taliban’s ministry for the propagation of virtue and prevention of vice constantly harass and humiliate female medical staff. “We try our best to do our jobs, but the pressure is unbearable. Many of us just want to quit. Sometimes, they insult us, claiming our clothing is ‘un-Islamic’.

“One day, our emergency ward was overwhelmed with patients. That section is for women only, and men are not allowed. But Taliban enforcers barged in and took away three female nurses, claiming their uniforms were inappropriate. They made them sign a pledge to wear longer clothing before letting them go. Even in life and death emergencies, instead of letting us treat patients they are instead arresting us over our clothing.”

• Names have been changed to protect the identity of the interviewees and some of the writers. A version of this story was originally published by Zan Times

An Afghan woman who risked her life to defend human rights in her home country before fleeing to the UK has been told by the Home Office it is safe for her to return after officials rejected her asylum claim.

Mina (not her real name) worked for western government-backed projects and was involved in training and mentoring women across Afghanistan, which left her in grave danger even before the Taliban took over in 2021.

“I assumed my asylum claim would be granted – I am from Afghanistan, I’m a woman, I worked with western governments,” said Mina. “The refusal was an absolute shock. Now every day I fear being sent back to my home country. Having a normal life here looks like a dream for me. I’m really suffering mentally.

“When I was working with western government projects I received security training about how to respond if I was caught up in a bombing or a kidnapping. Every day I was a few minutes or a few seconds away from bomb blasts.

“My heart beat so fast when I had to pass the checkpoints. Every morning when I said goodbye to my family to go to work I thought it might be the last time I saw them,” she said. “Some of my colleagues just disappeared. The Taliban changed the Ministry of Women’s Affairs to the Ministry of Vice and Virtue – proper, systematic elimination of women.”

The Home Office has previously generally accepted protection claims from women like Mina who could be targeted by the Taliban because of their high-profile work empowering women and who have provided evidence of their work with western government projects.

But in the most recent data for the last three months of 2024 immigration statistics show 26 Afghan women had their claims rejected. Overall 2,000 Afghan asylum seekers had their claims refused, an increase from 48 in the same quarter of 2023. The grant rate for Afghan cases has gone down from 98.5% in the last quarter of 2023 to 36% in the last quarter of 2024.

The 2025 Human Rights Watch report into Afghanistan documents a serious deterioration in the rights of girls and women and an increase in risks to their safety.

Although Mina explained in her Home Office asylum interview of the dangers she faced in Afghanistan because of the work she did a Home Office decision maker who rejected her claim, concluded that: “It is considered that you do not face a real risk of persecution or harm on your return to Afghanistan on the basis of your claimed adverse attention by the Taliban.”

However many of those Mina worked with prior to the Taliban takeover are either in hiding or have fled the country and these support networks have largely been destroyed.

“There are no compassionate factors in your case that warrant a grant of leave to remain outside the immigration rules,” the letter states.

“When I arrived here I felt safe,” Mina said. “I thought I would have a chance to live. In Afghanistan I had not been considered a human. I learnt to ride a bicycle here, something I was not allowed to do in my country. I was really full of hope that my life would change. But someone pressed pause on my life. I hope someone will press play again.”

Her solicitor Jamie Bell of Duncan Lewis said: “It is shocking that 26 Afghan women were refused asylum in the last quarter. However this is a particularly upsetting case where the Home Office states that a woman who risked her life defending women’s rights in Afghanistan would not be at risk on return. The UK should be proud to offer protection to an individual like her. This refusal letter is offensive to all those who defended western values in Afghanistan and who ought to be offered protection when they cannot safely return.”

A Home Office spokesperson said: “It is our longstanding policy not to comment on individual cases.”