The troubling rise of criminal abortion in Afghanistan

A 24-year-old Ghazni schoolteacher named Rodabeh lost her job a year ago when the Taliban government effectively banned Afghan girls from receiving secondary education.

A few months later, she learned she was pregnant and faced a stark choice.

“My husband told me he didn’t want the burden of raising a child and to go and throw it away,” Rodabeh explained to The New Arab.

"Rodabeh went to a private clinic for an ultrasound and learned the foetus had died. She lacked funds, so the remains stayed inside her for a few more weeks before she could pay for their removal"

Unable to afford an abortion, which is a serious crime in today’s Afghanistan and can result in a fine or even imprisonment, Rodabeh called her mother, who paid a midwife 5,000 Afghanis (roughly $60) for guidance.

The midwife prescribed Rodabeh eight tablets of Misoprostol, which is commonly taken to induce medical abortion. But that didn’t work. 

Over the next week, Rodabeh’s mother shelled out some $230 to two more midwives. One again used pills, while the other used an ampoule, a small glass container containing a murky liquid. Both failed, leaving Rodabeh with severe pains in her back and stomach.

Increasingly desperate, Rodabeh went to a private clinic for an ultrasound and learned the foetus had died. She lacked funds, so the remains stayed inside her for a few more weeks before she could pay for their removal.

In the Taliban’s Afghanistan, Rodabeh’s horror story is all too common. The New Arab found many women with similarly torturous experiences with dangerous, criminal abortions.

For years, abortion in Afghanistan has only been legal when going ahead with the pregnancy and birth would pose a threat to life.

For a sizable fee, aka a bribe, health centres and midwives will attempt to perform an abortion, either surgically or medically via pill.

"Black-market demand for Misoprostol tablets has increased exponentially in the past year"

The Taliban’s return to power did not result in a change of the law, as some might have feared, but it did make obtaining an abortion much more costly and difficult, further imperilling women’s lives. 

Black-market demand for Misoprostol tablets has increased exponentially in the past year, according to a Kabul-based nurse The New Arab spoke to on condition of anonymity.

For women without a prescription, which is nearly all of them, the price of pills has skyrocketed to 100 times the 2021 price. Only the wealthy can afford a medical abortion.

Meanwhile, family planning and health-related awareness is severely limited in Afghanistan. Many women receive dubious guidance from friends and family.

Some order oral contraceptives online with little understanding of the recommended dosage. Some submit to needle abortions, even though a slight error could rupture their uterus, leading to serious long-term damage or even death.

“Abortions are increasingly being performed at home by traditional midwives who often lack training and knowledge of post-abortion care,” says Batool Haidari, an Afghan clinical psychologist based in Italy.

Batool provides online advice to Afghan women — mostly unmarried teenagers and married women too poor to care for another child. “Many go on to have psychological and physical problems due to social stigma and unsafe procedures,” she said.

"For most, having another mouth to feed is simply unthinkable"

Masoomeh, a 41-year-old midwife in Kabul, used to receive one request for an abortion per week. But now she says she gets twice that many, with most of the women unable to afford another child. 

Taliban rule, along with severe drought and a hunger crisis, has pushed 97 percent of Afghans into poverty, according to the International Rescue Committee. More than half of the population relies on humanitarian aid.

For most, having another mouth to feed is simply unthinkable.

Nesa Mohammadi, former head of a midwife faculty in Kabul, said that one of the first steps the Taliban took after coming to power was to apply pressure on family planning centres and their sources of funding.

Nesa ran a private Kabul clinic for years, providing guidance on family planning and reproductive and sexual rights. Days after the Taliban took the capital, several members of the Islamist group visited the clinic to threaten her and her clients and smash up the place.

She said that while birth-control pills are theoretically available to the public, the Taliban has warned pharmacies and clinics not to sell them. “These days the Taliban are everywhere,” Nesa said.

This suffocating environment is compounded by cultural restrictions. In some areas, women without a mahram, or male chaperone, are turned away from health clinics and pharmacies that sell contraceptives.

Family pressures play a part, too. A woman that The New Arab spoke to on condition of anonymity said her mother-in-law forbade her from taking contraceptives. “In Afghanistan, women are often expected to live with the husband’s family,” says Nesa. “It’s not uncommon for the mother-in-law to intervene and forbid the use of birth control.”

Given the dire situation and lack of options, women are increasingly forced to seek illegal abortions that put their health at risk. Like Rodabeh, 31-year-old Sima Gull suffered through an abortion in June 2022.

Her husband sells fruit on a Kabul street corner, earning just enough to feed the couple and their five children. After deciding on an abortion, Sima’s sister took her to a woman they thought was a midwife. “All she had was some medicine and a blood pressure meter,” Sima recalled. “I’m not even sure she was trained.”

The woman inserted two pills into Sima’s vagina and gave her another two pills orally. Sima bled for four hours before miscarrying.

But that was not the end of it. Sima continued to bleed regularly for two months as her weight plummeted. Finally, her mother came up with the money for treatment at a private hospital.

“I was in severe pain and had no money,” said Sima. “I was worried I wouldn’t survive.”

Hannah Wallace is a London-based writer and researcher on armed violence and foreign affairs