ISIS is eyeing a different kind of explosion to expand its caliphate in the Middle East and into the future: A population boom that the black-clad jihadist army’s leaders believe will ensure the next generation of blood-soaked believers.

The terrorist group has combined its signature medieval brutality with a sophisticated push for pregnancies within the territory it controls in Syria and Iraq.  Propaganda touts a new nursing school, a pediatric facility and specific doctrine on the responsibility of fighters and their brides to procreate. An ISIS propaganda video released earlier this year featured Dr. Tareq Kamlehan, an Australian physician who joined ISIS, running a pediatric ward, boasting about the “good system that they’re running here” and urging medical professionals to join. 

“The idea of creating families to live within their Islamic State also provides further validation of ISIS vision as a legitimate nation unto itself,” said Clinton Watts, Fox Fellow at the Foreign Policy Research Institute. “ISIS believes the more people they can create in their image the better, and those born into violent ideology are usually the most committed to the course of their life.”

“They have massive problems paying the doctors and keeping the facilities running with power, equipment and medical supplies.”

- Daniel Koehler, German Institute on Radicalization and De-Radicalization Studies

In an attempt to show legitimacy as a professional and orderly government, ISIS is reportedly issuing birth certificates and related medical documents. ISIS leaders also have established specific guidelines for pediatric care for mothers giving birth within the caliphate, sources told One such directive forbids Caesarean births, calling them “un-Islamic” and asserting they could hinder future reproduction. Twisted tweets believed to come from within Islamic State show babies sleeping sweetly -- with guns, grenades and the ominous ISIS logo displayed beside them.

How to raise a “jihadi baby” has also been a key feature of ISIS publications, with one article, “Sister’s Role in Jihad,” underscoring that the “most important” role a female can play within the caliphate is to indoctrinate her offspring as early as possible. Mothers should encourage boys to play with toy guns and steer clear of TV, as it “mostly teaches shamelessness, anarchy and random violence.”

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Many of Islamic State’s mothers are sex slaves captured from Christian and Yazidi populations, as well as Western women who have traveled to the region to join the terrorist army.

Syrian activist group Raqqa is Being Slaughtered Silently reported in April that the terrorists had opened a nursing school in the Syrian city that serves as its headquarters, complete with standardized entrance exams and a mandate that nurses must speak fluent English so as to not put their patients’ lives at risk.

A member of the activist group, a collective of underground Raqqa residents who report from the city at great risk, told ISIS had opened a medical school for both male and female students, ages 18 to 30, “on condition that they must earn an average about 80 percent” in their final high school grades. Experts say the message shows that ISIS sees itself as much more than a terrorist group.

“ISIS is not only a terrorist group, but in the business of state building,” Anne Speckhard, a Georgetown University professor of psychiatry and security studies and author of “Talking to Terrorists” and “Bride of ISIS,” told “One of the central tenets of ISIS recruitment is their promise to build a utopian state where citizens will be able to live by Islamic ideals.”

The teams of medical professionals enlisted by ISIS are a combination of those willingly recruited into the barbaric faction and those forced to work against their will. But between patching up wounded fighters and trying to run its own version of a government health ministry, ISIS is almost certainly falling well short of the rosy picture its propaganda paints. Many medical professionals have fled the caliphate, and others have been killed for refusing to use their skills in the service of terrorists.

“They have massive problems paying the doctors and keeping the facilities running with power, equipment and medical supplies,” said Daniel Koehler, director of the German Institute on Radicalization and De-Radicalization Studies. “ISIS has even tolerated things like men and women working together in hospitals simply because they need the staff to continue and didn’t want them to flee. The situation is miserable.”

Residents of Mosul, ISIS’ main stronghold in Iraq, are occasionally permitted to go to Baghdad for surgery or medical treatment beyond the ability of the terror group’s medical teams, according to an Iraq-based U.S. defense official. But to do so, they must pay a fee amounting to about $6,700 and have a “sponsor” in Mosul. If they don’t return, their possessions are seized and the sponsor is killed.

The propaganda emphasis on pediatrics and health care is just one of many steps ISIS has taken in an attempt to disseminate the idea that the cities under its control are calm and competent. But those who have made it out alive tell a different story.

 “People everywhere are dying for food, clean water, jobs,” said a man who escaped Mosul after ISIS took over his home and held his family for a month earlier this year. “Anything good ISIS says is a lie.”