The limitations on choice: Palestinian women's childbirth location, dissatisfaction with the place of birth and determinants.
BACKGROUND
Analysing the Palestinian Central Bureau of Statistics (PCBS) Demographic and Health Survey 2004 (DHS-2004) data, this article focuses on the question of where women living in the Occupied Palestinian Territory give birth, and whether it was the preferred/place of choice for delivery. We further identify some of the determinants of women's dissatisfaction with childbirth location.


METHODS
A total of 2158 women residing in the West Bank and Gaza Strip were included in this study. Regression analysis established the association between dissatisfaction with the place of birth and selected determinants.


RESULTS
A total of 3.5% of women delivered at home, with the rest in assisted facilities. Overall, 20.5% of women reported that their childbirth location was not the preferred place of delivery. Women who delivered at home; in governmental facilities; in regions other than the central West Bank; who had sudden delivery or did not reach their preferred childbirth location because of closures and siege; because of costs/the availability of insurance; or because there were no other locations available, were significantly more likely to be dissatisfied with their childbirth location compared to those who birthed in private facilities, the central West Bank, and in locations with better and more available services.


CONCLUSIONS
The findings demonstrate that Palestinian women's choice of a place of birth is constrained and modified by the availability, affordability, and limited access to services induced by continuing closures and siege. These findings need to be taken into consideration when planning for maternity services in the Occupied Palestinian Territory.
Giacaman
Rita
R
Institute of Community and Public Health, Birzeit University Birzeit, Palestine. rita@birzeit.edu
Abu-Rmeileh
Niveen M E
NM
Wick
Laura
L
D000293:Adolescent; D000328:Adult; D018912:Arabs / Q000523:psychology / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006700:Home Childbirth / Q000523:psychology / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data*; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006801:Humans; D008427:Maternal Health Services / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D008877:Middle East; D036801:Parturition / Q000523:psychology; D017060:Patient Satisfaction / Q000706:statistics & numerical data*