The impact of warlike conditions on the lives of Palestinian women and children is far reaching. Beginning in September
2000, curfews, closures, siege and the parceling up of the country into small isolated entities have all led to a lack of access to
basic maternity services, rendering pregnant women and their newborns a highly vulnerable group. Because any discussion of
childbirth in the Occupied Palestinian Territories (OPT) cannot be separated from the larger historical context of international
health politics, we begin with a brief review of international historical trends in childbirth policies, focusing on the relationship
between discourse in the developed and developing world contexts to show how these models have intersected and diverged. We
point to the similarities between the OPT and other developing countries, but also highlight the specificities that characterize the
Palestinian experience today that include local political systems, medical dominance, professional group interests and the politics
of gender, as well as the legacy of colonialism intertwined with an ongoing national conflict. We then provide a review of the
history of childbirth in the OPT and analyze the various forces that led to the emergence of today’s chaotic and contradictory de
facto policies and practices. By assessing the health policy environment, we demonstrate the seeming impossibility of developing
national level childbirth policies, given the current political conditions and a mix of other determinants that are not all within
Palestinian control. Finally, we emphasize the importance of establishing a process as opposed to a blueprint of health policymaking
based on people’s immediate and long-term needs in all areas of the country. We also propose interim measures that rest
on the notion of developing decentralized sub-strategies relevant to different zones of political reality and stages of system and
human resource development, aiming at combining survival imperatives with those of improving women’s birth experiences and
women’s health.