Thursday, January 04, 2007

On Giving Birth in Iraq

The Washington Post has a lengthy article on the perils of childbirth in Iraq, "Iraq's Woes Are Adding Major Risks To Childbirth." The piece mentions the state of the healthcare system, road closures, curfews, and violence and doctor kidnapping as barriers to women receiving appropriate care during birth. As a result, it claims, women are resulting to skipping prenatal care, scheduling elective c-sections to avoid being caught out after curfew, and utilizing neighborhood midwives (although I'm not convinced that using midwives should be lumped in the same sentence as avoiding care, which the Post piece does). One obstetrician reports carrying a gun to work, having had the ultrasound machine stolen, and having received 3 death threats. Women also have difficulty arranging to go to the hopsital - "During curfew, ambulance drivers and even police officers sometimes charge women for rides to the hospital, or refuse to take their husbands out of fear that they are suicide bombers, doctors said." Another obstetrician reports an observed rise in birth defects, which she attributes to women skipping prenatal care to avoid going out to see the doctors, ans says that she used to see one baby a week with congenital abnormalities but now sees 5 or 6.

The piece also follows the story of one woman, Ibrahim, who decided to wait until morning to go to the hospital to give birth due to her fears. When she finally arrived, there was no obstetrician or anesthesiologist, and a surgeon has just been kidnapped. Nurses tried to extract the baby with forceps, failed, and told her to go to another hospital. Ambulance drivers refused to take her, resulting in a 30 minute drive. When she arrived at the second hospital, the had an emergency c-section, but the doctors told her that her baby had been killed by the forceps applied at the first hospital. This is no way to give birth, and unfortunately, there are no quick and easy solutions.

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MeSH Tags: Health Services Accessibility; Iraq; Medically Underserved Area; Parturition

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