Dying to give birth: obstructed labour in the Hindu Kush



For many years my desire has been to practise obstetrics in countries with high maternal mortality rates, where obstetric skills and knowledge are sparse. I chose Afghanistan, with its terrible history of oppression of women, and after obtaining my CCST (Certificate of Completion of Specialist Training), I started working in Badakhshan province in the northeast of the country. It is in this province that the world's highest maternal mortality ratio was recorded. The number one cause of death is obstructed labour. This article is an attempt to shed some light on this remote corner of the world, and to look at the reasons for these shocking statistics and some possible solutions.