Azerbaijan has the highest infant mortality rate in Europe, due in part to a lack of sex education for girls, according to health experts.

The infant mortality rate has improved over the past decade. But Azerbaijani doctors and other health experts warn a culture that restricts girls’ education about sex means women are ill prepared for pregnancies and unlikely to seek vital prenatal care.

In the case of 34-year-old Baku resident Nazli (not her real name), a fatal combination of poverty and ignorance resulted in the death of two children. She nearly lost a third because she did not go to the doctor during her pregnancy.

“She gave birth seven times. Two children were stillborn. The rest are growing up, thank god. But she never went to a doctor during pregnancy, or after the birth,” notes her mother, Latifa Allahverdiyeva.

Nazli says she always meant to see a doctor, but never quite found the time to do so. In her most recent pregnancy, she thought she still had a month to go when labor started.

“I heard the heartbreaking cries of children at a neighbor's home. I went to see what was going on,” recalls her neighbor, Khayala.

“Oh my god, I will never forget that scene ... In the middle of the room, a woman was lying in a pool of blood, unconscious, with four children crying, ‘Mother, don’t die, Mother’.”

It was Nazli's fifth pregnancy. When Khayala saw the blood, she thought she was dead. An emergency cesarean section saved Nazli and her baby. But not all women are so fortunate.

Azerbaijan had the highest infant mortality rate in Europe in 2018, according to UNICEF. In that year, there were 147 infant deaths out of 13,898 registered births.

While some health experts have said official statistics underreport the problem, Baku-based Republican Perinatal Center notes that, based on the current population, “maternal mortality and infant mortality have declined dramatically in the perinatal period.”

The drop has been credited in part to government programs, like the Ministry of Health's pregnancy portal. The portal (www.hip.az) provides information about pregnancy, including the importance of regular check-ups and other issues.

This year the government also announced a sex education curriculum for schools around the country, EurasiaNet.org reported. The program, a first for the country since the end of the Soviet Union, has already been piloted for 60,000 seventh and ninth grade students.

The school-age program could make a real difference, according to health specialists, who fear that women around the country are putting themselves and their babies at risk due to a lack of education and information.