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Moments after an infant was born to a Turkish couple — an Islamic State fighter and his young wife — they tried to dress their newborn son in a custom-tailored military uniform. The father proudly declared that the child would grow up to become an Islamist militant. Nasr was revolted. She said she persuaded the father not to use the uniform, telling him the material was too coarse for the baby’s delicate skin.

Nasr, 66, is among the millions who lived under the Islamic State’s violent and austere rule in Syria and Iraq, but she witnessed a side of the militancy that perhaps no other outsider did. She was coerced, she said, into delivering countless babies for Islamic State families, attending the most intimate moments of their secluded lives, which she described as alternately ordinary and grotesque.

During the three years she was shuttled by taxis and gunmen to the homes of Islamic State families, most of them foreign, Nasr’s emotions ran from fear to anger to helplessness, she said. There was none of the joy or pride that had sustained a career of delivering babies for a generation of Raqqans.

The children of the caliphate were themselves treated as props. They were central characters in Islamic State propaganda videos, which often showed children of diverse European, Asian and African backgrounds studying Islamic State teachings, or playing and training with weapons. Other videos purported to show adolescent boys executing people deemed apostates or enemies.

The young women were mostly elated upon becoming mothers, and in a practice that seemed ignorant to Nasr but is actually increasingly common in the West, they all insisted on holding the newborns tight and breast-feeding them even before the umbilical cord was cut.

But the husbands imposed harsh rules. They forbade Nasr to give the women painkillers or other medicine while they were in labor. She said some of the women went through 10 hours of labor without the opioids or muscle relaxers that Nasr had routinely given to women in the past.

Mostly, however, she remembered her experiences in delivering Islamic State babies with revulsion and anger. She felt humiliated by how she was treated. Nasr has a soft face and slow, labored walk, but she is a proud woman who knows her craft and is accustomed to respect. She also has a sharp tongue and has been used to giving commands and guidance, not being ordered about.

On the wall outside her home, largely spared the devastation suffered by her neighbors, hangs a sign advertising her services. It bears the name she’s widely known by: Umm Alaa. It means Alaa’s mom, a nickname she acquired after the birth of a son who would go on to become a doctor in Raqqa. Three bullet holes blemish the sign, a reminder of the ferocious battle last year as U.S.-allied forces ousted the Islamic State from the city.

Nasr said she had initially tried to resist working for Islamic State couples, but the consequences of not cooperating soon became clear: imprisonment or even execution in a public square. Her husband, a slightly built, bookish retired Arabic teacher, had been jailed for a few days after he tried to mediate between the feared Islamic State morality police and a neighbor who had run afoul of their strict code.

Maternity ward services had been offered free by the Syrian government, but Islamic State administrators began imposing fees for these services at the hospital to raise revenue for their nascent city-state. They charged the equivalent of about $20 for a regular birth and $50 for a Caesarean section.

As the group consolidated its power in Raqqa in late 2014, Nasr and her husband were told by their Kurdish neighbor that he was being evicted. In his place came a Kenyan man, his wife, three adult sons and German daughter-in-law. Word spread in the neighborhood that he was an administrator for the Islamic State who went by the nickname Abu Walid and was in charge of the affairs of widows whose militant husbands had died fighting.

Nasr declined, pretending to be too old and frail and saying she had retired from the profession. Abu Walid, who was armed, didn’t accept her refusal. He insisted she accompany him to the large house. There, Nasr recalled, she found pregnant women from an astonishing array of nations: There were Tunisians, Saudis, Egyptians, Yemenis, Somalis, Moroccans, Irish women, French women, Germans, Russians, Turks and women from the Caucasus and African countries she could not identify.

She was also struck by the Syrian wives. The youngest were 13 and the oldest no more than 15. Over the next three years, Nasr said, she would sadly note that the Syrian wives were never older than 18, an illustration of how the new rulers of Raqqa, mostly foreigners, had plundered the locals.

In the final days of the battle to evict the militants in October, she was summoned to the house of a Somali fighter and his Yemeni wife. The woman was already in labor and had a bleeding head wound. Nasr was told by the fighter that he was riding his motorcycle at high speed to avoid the U.S.-led coalition’s airstrikes and that his wife had fallen off the back of the bike.

Sitting in her house, warmly decorated with caramel-colored floor cushions and an ornate peach Persian-style rug, Nasr said she has recently been reflecting on her time as the Islamic State’s preferred midwife, grappling with the morality of her actions.

Days before his 40th birthday in October, Nasr’s son Alaa had headed out into the city during an aerial barrage to provide medical attention to victims. Nasr had begged her son not to go, but he told her it would be a dishonor to him as a doctor to not help people in need.