Birth at the Checkpoint, the Home or the Hospital? Adapting to the Changing Reality in Palestine

Abstract

Women have the right to feel safe during childbirth and to choose the place where they want to give birth. This certainly has not been the case for Palestinian women living under occupation in the past two years. The emergency situation has changed the parameters of maternity care. In the previous decade, the trend had been toward a decrease in home births, with ninety per cent of pregnant women in the West Bank giving birth in maternity facilities in 1999. Recently, however, the frequent and severe closures, the extended curfews, and the unpredictable emergency situation has led to a considerable increase in childbirth at home or in doctors’ clinics. During these periods of siege, midwives (both formally trained ones and the dayas or traditional birth attendants), physicians, and even family members were called upon to be birth attendants. Birthing women have shown strength and courage despite the atmosphere of fear linked to the siege and the periodic inability to reach the hospital in case of emergency. Midwives have calmed many anxious pregnant women, reassuring them that they will accompany them throughout the birth and give them the necessary encouragement and support that they need to give birth successfully, in spite of the obstacles. Some health professionals, unaccustomed to birth outside of the hospital, had to overcome their own anxieties in order to assist pregnant women and deal with the complications in the community. Many of the births resulted in healthy babies. However, some of the cases ended in tragedy with the death of the infant and in rare cases with maternal death, when the laboring woman was delayed at the checkpoint