Perceived physical and psychosocial adaptations during the perinatal period in Palestinian women and men in a remote West Bank village : a qualitative study

Abstract

Background Coverage and quality of postnatal care in the occupied Palestinian territory, and information about morbidities and challenges that families might face, remain inadequate despite its centrality to ensure maternal and infant health. In our planning of a postnatal home-visiting programme, we explored rural women’s and men’s views about physical and psychosocial adaptations before, during, and after childbirth in the Beit Liqya village situated in Area C (60% of the West Bank placed under undivided Israeli security and infrastructural control). Methods We undertook four focus groups with married women and one with married men of different ages in 2012, using an open-ended guide. Participants included 44 women (aged 21–70 years; nine were pregnant, four were childless, 31 were not pregnant and already had at least one child) and nine men (aged 24–71 years). Ethical approval was obtained and participants provided verbal consent. Data were analysed with thematic analysis. Findings The diversity of participants provided a rich perspective on societal changes. Five main themes emerged: transitions in men’s paternal and spousal roles and women’s lifestyles; the institutionalisation of childbirth; formally trained midwives and physicians replacing the village daya (a traditional birth attendant skilled through apprenticeship); psychosocial adaptation after birth; and views about health services. Nowadays, men participate more in pregnancy, childbirth, and post-partum family life than they previously did. However, the diet of women is reduced in nutrition; they are not as active during pregnancy because of reduced agricultural labour and are more focused on medical controls, such as frequent antenatal visits and laboratory tests. As noted by a woman that “[there are] too many antenatal visits, women do not eat breakfast, although there are many available options in houses these days, they eat unhealthy junk food”. The postpartum period was viewed as a crucial time for recovery with a need for strong family support. Female participants expressed a preference for female health-care providers. Interpretation Findings deepened our understanding of rural women’s and families’ needs and views regarding pregnancy, birth, and postpartum. Changes in the experiences of Palestinian women and men during the perinatal period should inform changes to policy and practices to tailor accessible and effective community programmes that are responsive to these families’ needs and of those in other marginalised populations.