No safe place for childbirth: women and midwives bearing witness, Gaza 2008–09

Abstract

Women seek to give birth in a place where they feel safe, protected and secure. However, in conflict settings, many are forced to give birth in dangerous and frightening situations, where even the most rudimentary help and protection is unavailable. This study, based on interviews with women who gave birth and midwives during the 22-day Israeli attack on Gaza in December 2008 -January 2009, illustrates the vulnerability and trauma women experience when there is no safe place for childbirth. They recounted their overwhelming fear of not knowing when they would go into labour, not reaching a hospital or skilled attendant during the bombing, complications in labour without emergency care, and fear for the safety of their families and being separated from them. Most of the midwives were unprepared both materially and psychologically to attend births outside a hospital setting, while physicians were overwhelmed with severely injured patients. The capacity of midwifery care to keep birth normal whenever possible is particularly crucial in situations of political instability, conflict, poverty and disaster. Planning for emergency care by mapping the location of midwives, supplying them with basic equipment and medications, and legitimizing their profession with an appropriate scope of practice, licensing, back-up, and incentives would facilitate their ability to respond to birthing women's needs.

Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda

“…Furthermore, Wick and Hassan [ 56 ] have suggested better support, supervision and equipping of key EmONC personnel, especially midwives to be able to assist pregnant and birthing women and newborns at any time and in any circumstances. Kongnyuy et al [ 57 ] have equally identified improvements in human resources, referral system, health infrastructure, health information system among others as important strategies to overcome the barriers to EmOC services in resource poor settings like Burundi and Uganda.…”

Assessing Community Based Improved Maternal Neonatal Child Survival (IMNCS) Program in Rural Bangladesh

“…In some instances, decision to deliver at a facility doesn’t depend on the woman but on the husbands, mother-in-laws, community heads, soothsayers or traditional healers [ 23 , 24 ]. Many women prefer and seek to give birth under conditions where they feel safe, protected and secure and in most cases it is home [ 25 , 26 ]. However, increased level of awareness regarding the safe delivery practices at the community level, prompt referral, arranged transport and proper management in the facility ensured by IMNCS intervention may have caused increased facility delivery compared to that of home deliveries in intervention districts overtime.…”

Magnitude and trends of inequalities in antenatal care and delivery under skilled care among different socio-demographic groups in Ghana from 1988 – 2008

“…In some instances, the decision to deliver at a facility is not up to the woman but is made by husbands, mother-in-laws, community heads, soothsayers or traditional healers [22, 23]. Many women prefer and seek to give birth under conditions where they feel safe, protected and secure [24–26]. …”