Routines in maternity care: evidence from the Arab world

Tamar Kabakian-Khasholian, American University of Beirut

This paper presents the first four studies documenting normal labour and delivery practices in Arab countries, Lebanon, Syria, Palestine and Egypt, and compares these to evidence-based practice. The studies were separately conducted through the regional Choices and Challenges in Changing Childbirth network based at the Faculty of Health Sciences, American University in Beirut. In Lebanon, Syria and Palestine, data were collected from hospital records and providers in a representative sample of hospitals. The Egyptian study conducted direct observations of labouring women in Egypt’s largest obstetrics teaching hospital. Compared to WHO classification, most practices do not follow scientific evidence. Those with known beneficial effects (rooming in, companion during delivery) are not widely used, when others known to be unnecessary or harmful (perineal shaving, enema, episiotomy) constitute the routines. A number of difficulties that need to be overcome to implement evidence based provision of care in these settings are discussed.