Afghanistan has one of the highest maternal death rates in the world, despite gains in women’s health over the past 20 years (see go.nature.com/39burgc). Experience suggests that the Taliban’s takeover of the country will further imperil mothers’ health and well-being.

During the previous reign of the Taliban (1996–2001), the maternal and neonatal death rates worsened as a consequence of the complex synergy of social, demographic, medical, economic and cultural factors (S. A. M. Najafizada et al. Cent. Asian J. Glob. Health 6, 240; 2017). Restrictions to women’s lives included allowing only female health workers to examine them, limited access to quality health services — particularly obstetric care — and minimal opportunities for education and work. These increased the risk of giving birth at home with no prenatal or natal care (C. Palmer Lancet 352, 734; 1998).

The United Nations 2030 goals for sustainable development include reduction of global maternal mortality to less than 70 deaths per 100,000 live births. Afghanistan’s latest figure of 638 per 100,000 is now more likely to grow than to shrink. In our view, rectifying this should be an international priority.