better chance of carrying a child to term. Whether patients actually use any form of contraception has less to do with ideology or a conservative husband and more with the practical circumstances of life here. Too much snow, heavy rain, or a mudslide in the spring mayblock the roads from a small village when time comes to refill a prescription or submit to another injection. Or there simply may be no car, or no gas for the car, or no one to drive it. That also contributes toeighteen thousand Afghan women dying each year of complications from childbirth; about fifty women per day, or one every half hour.
In another room, three women from the same village are in various stages of pregnancy with complications, but the cost of a car ride could not be justified for just one, or even two of them. So the first two had to wait for the third to go into labor. Only then were they all three driven together, as fast as the car would go. Despite efforts to stem maternal mortality, Afghanistan still ranks among the world’s worst countries to give birth in,on par with the poorest and most war-torn nations in Africa. But the odds for survival at this clinic, in the middle of a battlefield, are better than at a home birth.
“She is forty,” Dr. Fareiba says of a patient in a postdelivery room. The woman is lacking several front teeth, and has bracelets stacked up on each arm. “A miscarriage. But she has ten live children. Only girls. So she tries for a son, again and again.”
When a new wife is blessed with two or three sons as her first children, she will not be pressured to have many more after that. If a few girls follow, that is fine, too. But at a streak of only “girl, girl, girl,” in the doctor’s words, most women will keep trying for a son. It’s a one-sentence explanation to the population question: A total of four or five children is perfectly acceptable to most parents in Afghanistan—but only if that number includes mostly boys.The life expectancy of a woman here is forty-four years, and she spends much of it being pregnant. Most couples know how to limit pregnancies if they want to, but the pressure to have another son often overrides any concern for a woman’s survival.
Dr. Fareiba pokes into the blanket of a new mother, who lies on a bed facing the wall. She has been silent since her delivery. The doctor sweeps up the small bundle from her side and turns to the nurse trailing her every step. They nod at each other: Yes, it’s a girl.
She is only a few hours old, and she does not have a name yet. Her eyes have been lined with kohl, “for magical luck,” and to protect her from the evil eye. The baby blinks a little, and her tiny mouth gasps a few times. She is perfect, down to her tiny, grasping fingers. Yet to many in Afghanistan, she is
naqis-ul-aql
, or “stupid by birth,” as a woman equals a creature lacking wisdom due to her weak brain. If she survives, she may often go hungry, because feeding a girl is secondary to feeding a son in the family, who will be given the best and most plentiful food. If, in her family, there is a chance of the children going to school, her brothers will have priority. Her husband will be chosen for her, often before she reaches puberty. As an adult, very few of life’s decisions will be her own.
L OOKING AT THE revered Dr. Fareiba, though, it is hard to imagine that she would allow a man to rule any aspect of her existence. She herself has defied tradition by working under almost every form of government in the past twenty years, as well as no government at all, since there was always a need for female doctors. Dr. Fareiba has delivered “maybe one thousand babies,” by her own estimate.
“But why do only sons count here? What is it that women cannot do?” I ask.
Dr. Fareiba raises her hands in the air to express frustration. She already explained this: It is not about capability. Men and women just have different roles and different tasks. It is about how