Wick Laura, Hassan Sahar
Institute of Community and Public Health, Birzeit University, Birzeit, Palestine.
Reprod Health Matters. 2012 Dec;20(40):7-15. doi: 10.1016/S0968-8080(12)40648-6.
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.
女性都希望在一个能让她们感到安全、受保护且安心的地方分娩。然而，在冲突环境中，许多女性被迫在危险和令人恐惧的情况下分娩，在那里甚至连最基本的帮助和保护都无法获得。这项基于对在2008年12月至2009年1月以色列对加沙为期22天的袭击期间分娩的女性以及助产士的访谈所开展的研究，揭示了在没有安全分娩场所时女性所经历的脆弱性和创伤。她们讲述了自己对不知何时会临产、在轰炸期间无法抵达医院或找到专业医护人员、分娩时出现并发症却得不到紧急救治，以及对家人安全的担忧和与家人分离的极度恐惧。大多数助产士在物质和心理上都没有为在医院外接生做好准备，而医生则忙于救治重伤患者。在政治动荡、冲突、贫困和灾难的情况下，助产护理尽可能保持分娩正常的能力尤为关键。通过绘制助产士的位置图、为她们提供基本设备和药品，并通过适当的执业范围、许可、后备支持和激励措施使她们的职业合法化来规划紧急护理，将有助于她们满足分娩女性的需求。
