This study demonstrates that women in Herat Province, Afghanistan have an extraordinarily high risk of dying during pregnancy and childbirth and the highest maternal mortality ratio in the world outside of Africa. It shows that prenatal care, maternal health care facilities and trained health care personnel are virtually non-existent in the region and it provides evidence that violations of human rights contribute to preventable maternal deaths. These factors include access to and quality of health services, adequate food, shelter and clean water, and denial of personal freedoms such as freely entering into marriage, access to birth control methods and possibly control over the number and spacing of children.