Borders, bodies, and barriers: Legal vulnerabilities and reproductive health challenges of Afghan women immigrants in the host society of Pakistan.

Abstract

The study aimed to investigate the influence of legal status on reproductive health service availability for Afghan women immigrants and their adopted coping methods with obstacles. The study employed a qualitative design utilizing narrative in-depth interviews with twelve undocumented Afghan women, supplemented by five key informant interviews and field observations. The study findings revealed that legal uncertainty, along with cultural constraints, act as the main factor preventing undocumented women from accessing public healthcare facilities through their inability to present Proof of Registration (PoR) cards and breaking norms. Afghan women avoid hospital care because they face discriminatory treatment in addition to receiving unsupportive attitudes from medical workers and worries of deportation. Male guardianship policies combined with gender norm expectations reduce women's freedom to make reproductive decisions. As a result, many rely on informal healthcare providers, such as traditional birth attendants, despite the risks of maternal and neonatal complications. Using intersectionality and structural violence theories, this research contributes to migration and gender studies, as well as health inequity research, and recommends practical solutions for rights-based care policies. These theoretical frameworks illuminate how intersecting axes of oppression collectively shape reproductive health access and outcomes for undocumented Afghan women in Pakistan.