Midwives Risk Baghdad Curfew

The nighttime curfew that keeps cars off the roads in Baghdad has brought an increased demand for visiting midwives, as expectant mothers stay at home rather than risk a late-night drive to hospital.

It is just as dangerous for midwives to be out during the hours of curfew, but they say they feel compelled to help the women.

Baghdad doctors say it is better for babies to born in hospital, but in an emergency a family often has little choice but to go out looking for a midwife - sneaking through back streets to avoid being stopped - or to phone around in hope someone will chance the drive.

The curfew, which runs from 11 pm to 6 am, is meant to keep insurgents from planting bombs and staging attacks in the middle of night. Any car travelling after curfew is considered suspect by Coalition or Iraqi patrols.

Sameera Hassan, a midwife for 15 years, was stopped by an American patrol as she and her husband drove to a pregnant woman’s house in the middle of the night. The Americans asked them why they were out so late.

“We couldn’t communicate with them because there was no translator,” she said. “We tried our best to understand each other, but it was useless.”

In desperation, Hassan held her hands out to imitate the shape of pregnant woman.

“At last they understood, but they didn’t believe us. So they came with us to the lady’s house. They saw that she was in a very bad state, and they accompanied us to the hospital. They asked us to name the baby Maria, as in the Virgin Mary. Since we have a similar name in Islam, the family agreed,” she recalled.

“I got paid and survived the dangers of that night.”

Some families pay extra for after-hours visits, but it very much depends on how well-off they are, said Um Ibrahim, who has been a midwife for 25 years.

“There are families who don’t have enough money to pay for food, which I notice when I’m in their homes, so sometimes I don’t take any pay or reward,” she said. “But as for the rich families, they pay me well and give me a bonus because they appreciate it, particularly during the night.”

Um Mahmud, who has been delivering babies for 40 years, said no extra money is worth the risks of travelling at night. She is afraid of being shot by either the Americans or the insurgents, or of being kidnapped.

Her solution was to section off part of her own house and fit it out with oxygen and other medical equipment to provide overnight accommodation for up to five women, so that neither she nor they will have to make an emergency trip during the night.

“I make sure that both [mother and baby] are in good condition, and they can then leave my house safely,” she said.

Dr Laheeb Azawee has also been asked to deliver babies in her home, but she refuses to do so.

“Delivering babies at home isn’t easy. You need a room with expensive equipment that is unavailable in my or any other doctor’s home,” she explained. “The birthing process does not only involve bringing the baby out, it also means taking care of the health of mother and baby. Sometimes the mother will have bleeding which needs immediate attention, and that cannot be done by midwives.”

But getting to hospital can be a problem even in the daytime. With bombings and shootings happening all the time, ambulance drivers are often too busy to transport pregnant women.

“The hospitals are always full of the injured and dead due to the increase in explosions,” said ambulance driver Hisham Emad. “I just looking out for the smoke and head for the blast site. Sometimes I get hit by other vehicles or even American trucks.”

Emad has seen two babies delivered in his ambulance while he was half way to hospital, but says that “there’s a very limited number of ambulances, so they’re used only for bomb casualties and rarely get sent out for imminent births”.

Police are often called on to help out instead.

“Many families dial our number and ask us to accompany them during the night curfew to protect them against being fired on by the Americans,” said policeman Ghazawan Kareem.

Another officer, Haider Khalil, said he and his colleagues try to take families to hospital whenever they are asked.

“Sometimes the father names the baby after the driver who took them, as a reward,” he said.

For some, no promises of a police escort or even a home visit from a midwife will do.

Iman Abdul Majeed has three children and all the pregnancies were difficult, and her fourth child is due any day now. “I know my condition needs more medical care than others,” she said. “I don’t want my kids to lose me and become orphans, so I’ve decided to go to the maternity hospital at four every afternoon and stay there until early morning. The baby may come at any moment.”

Sahira Rasheed is an IWPR trainee in Iraq.