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The birth of hope

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But many problems remain. Poor, unpaved roads make it difficult for people to get access to healthcare, including the services of midwives. The result of more than two decades of war and a fundamentalist regime mean many families still forbid women to see a male care provider - making the role of midwives like Kuchi all the more crucial.

This morning, on a typical day in the life of an Afghan midwife, Kuchi is visiting Kabul's poorest neighborhoods. With her is a list of houses where pregnant women live. When she comes into the Sakhi home, they behave as if a great dignitary has arrived, and then a crowd gathers around to watch her go to work.

Kuchi, who has six children of her own, asks the three women who are due next month to approach her. Each is a wife of one of the family's eight sons; a new wife usually moves in with her husband's family. Kuchi moves her hands over each rounded belly, listening with a rudimentary stethoscope for a baby's heartbeat.

Then Kuchi and her midwife partner, Gul Ghuta Musleh, lead an informal class in how to deliver a baby.

Assembled on the carpet are all the women of the extended family, as well as girls from the age of 10, some of whom can expect to be mothers in the next four to five years.

Most of the women will bear their children here, in this cement room where a chilly draft wafts through windows that sit askew.

Hajira is on her sixth birth, although she's already lost two infants along the way. A baby-faced woman in a dark-blue scarf, she looks too young to have been through so much. But at 20, she's already been married for six years, and had one pregnancy a year.

"We didn't know what to do, really," says Hajira. "Now we know more, because [the midwives] come to visit and they keep coming back.

"She's always reminding us what to do," the young woman says of Kuchi, "because it's good to hear it more than once. Sometimes we forget."

Next, the midwives hand out sealed bags, free kits from the United Nations that come with the bare essentials - a clean sheet and plastic, plus a string and a razor for cutting the umbilical cord.

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