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Providing quality maternity care within the emergency care packages for internally displaced populations in war-affected areas is somewhat challenging, although very essential. In this retrospective study, we describe the experiences and health care seeking behaviors of 1,015 pregnant and postpartum women during the 2006 war in Lebanon. Women reported interruptions in regular maternity care and experienced more complications during this period. Availability of health services and experiences of complications were the most important determinants of health care seeking behaviors. Maternal health services should be a part of any comprehensive emergency responsiveness plan, catering to women's needs in war-affected areas.

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Objectives  To document facility‐based practices for normal labour and delivery in Egypt, Lebanon, the West Bank (part of the Occupied Palestinian Territory) and Syria and to categorise common findings according to evidence‐based obstetrics. Design  Three studies (Lebanon, West Bank and Syria) interviewed a key informant (providers) in maternity facilities. The study in Egypt directly observed individual labouring women. Setting  Maternity wards. Sample  Nationally representative sample of hospitals drawn in Lebanon and Syria. In the West Bank, a convenience sample of hospitals was used. In Egypt, the largest teaching hospital's maternity ward was observed. Methods  Shared practices were categorised by adapting the World Health Organization's (WHO) 2004 classification of practices for normal birth into the following: practices known to be beneficial, practices likely to be beneficial, practices unlikely to be beneficial and practices likely to be ineffective or harmful. Main outcome measures  Routine hospital practices for normal labor and delivery. Results  There was infrequent use of beneficial practices that should be encouraged and an unexpectedly high level of harmful practices that should be eliminated. Some beneficial practices were applied inappropriately and practices of unproven benefit were also documented. Some documented childbirth practices are potentially harmful to mothers and their babies. Conclusion  Facility practices for normal labour were largely not in accordance with the WHO evidence‐based classification of practices for normal birth. The findings are worrying given the increasing proportion of facility‐based births in the region and the improved but relatively high maternal and neonatal mortality ratios in these countries. Obstacles to following evidence‐based protocols for normal labour require examination.

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