By Sarah Chynoweth and Ada Williams Prince
"Every time a bomb went off I thought the baby was coming."
This is what a young Iraqi woman told us about her experience giving birth in Iraq. Many Iraqi women have demanded caesarean sections rather than risk delivering their infants during war, even though some were well short of their due date, putting the mother and child's health in danger. The woman, a gynecologist in fact, fled to Jordan soon after the delivery with her baby and husband in search of safety.
Although life in Jordan is free of gunfire and explosions, it is not free from fear, particularly for Iraqi women and girls.
If you are an Iraqi woman in Jordan, your life is filled with dread and uncertainty. Since Iraqis do not have legal status there, they are afraid of being caught by the authorities and deported back to Iraq--even though this does not occur very often. Because of this, many are afraid to come forward to receive health care, even if the services are available and accessible.
If you are a poor Iraqi woman in Jordan, your life is even more difficult. There are tremendous barriers to getting adequate health care: women with limited financial resources often have less knowledge of what medical services are available and how to access them. Their options are to go to government supported clinics or those run by international agencies. Although services are relatively inexpensive, for families without income it can be a tremendous financial burden. For poor women who are pregnant and unmarried, they may decide to have their baby outside of a hospital or clinic because they cannot afford the cost of care--which puts them at risk if they have a problem during pregnancy.
Doctors can also deny care (although an infrequent occurrence) to unwed pregnant women based on "moral reasons." In fact, pregnant women who are not married must be reported to the authorities because Jordanian law prohibits sex outside of marriage. Therefore, children born out of wedlock can be taken from their mothers if a legitimate father is not identified. This applies to all women--both Jordanian and Iraqi.
Iraqi women face additional obstacles. For refugees who have been raped, the likelihood of receiving life-saving medical care is extremely rare. Jordanian law requires medical and social service providers to report rape cases to the police. Yet rape survivors are terrified of coming forward--not only due to the humiliation and stigma, but because they may become victims of honor killings, having "shamed" their families. For those few brave women who do come forward--despite the fear and risks to her and her family--medical care is rarely available. Doctors are generally not aware of emergency contraception, which can prevent pregnancy, and those who are aware can decide not to prescribe it based on cultural mores. Many doctors also do not know that drugs to minimize HIV transmission exist, and thus almost never prescribe them.
Despite these trying challenges for Iraqi women, progress has been made on a number of levels: international agencies are providing general health services, which were not previously available. And recently, the Jordanian government has focused more on reproductive health through the establishment of a woman and child health department, which includes a special unit on violence against women within the Ministry of Health. It is also in the process of developing its first national protocol on reproductive health.
Yet although Iraqi women are no longer in the shadow of war, their health and safety remain in jeopardy.
Sarah Chynoweth, Reproductive Health Program Manager, and Ada Williams Prince, Senior Advocacy Officer, of the Women's Commission for Refugee Women and Children have recently returned from Jordan where they were following up on a reproductive health field mission undertaken in 2007 which found virtually no reproductive health services for Iraqi refugees. While much has improved, life-saving reproductive health for women is still not a priority.
Please e-mail PostGlobal if you'd like to receive an email notification when PostGlobal sends out a new question.