Assessment of Reproductive Health Access in Occupied Palestine

Written By Nikki Mahendru

Laura Norman

The WHO defines reproductive health as: “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and its functions and processes. Reproductive health implies that people are able to have a satisfying and safe sex life, and that they have the capability to reproduce and the freedom to decide if, when, and how often to do so.” What exactly does this mean? Because health is not just the absence of disease (physical well-being), good reproductive health requires:

  1. Sexual freedom--the ability to choose if, when, and how often to engage in sexual intercourse

  2. Access to contraceptives and family planning methods

  3. Ability to love whomever you want without fear of social and legal consequences

In order to assess the quality of reproductive health in Palestine, this requires an understanding of the history of the country and how that has affected access and quality of reproductive healthcare, as well as the state of sexual freedom for Palestinians.


History of Palestine and Israel

Palestine had been a province of the Ottoman Empire for over 400 years. After the collapse of the Ottoman Empire in 1917, the British Empire released the Balfour Declaration, which showed support for “the establishment in Palestine of a national home for the Jewish people” (United Nations). This marked the beginning of the emigration of Jewish people from eastern Europe to Palestine, which skyrocketed during World War II and the Holocaust. The Zionist movement widely supported this. The Zionist movement is a group that believes in the right for Jewish people to have their own state in their ancestral homeland, which is the land that Palestinians occupied. In 1948, the Nakba, or the mass displacement of Palestinians from their homes by Jewish people, occurred. The United Nations proposed a “two-state solution” which would allow for the existence of an Arab and Jewish state, with Jerusalem being under the UN’s control due to its significance to the Abrahamic religions. Palestinians did not support this solution. Over the years, the newly created state of Israel began to slowly take over Palestinian land, which led to two intifadas, or uprisings. In 2005, Hamas won an election to control the Gaza Strip, a small section of land where Palestinians live. Hamas is a Palestinian political and military organization that seeks to liberate Palestine and annihilate Israel” (El Deeb, 2023). This resulted in Israel imposing a blockade on the Gaza Strip, where no humans or goods could enter or exit (Alfonseca, 2023). As a result of this, 81% of people in the Gaza strip live below the poverty level and 63% experience food insecurity (United Nations). Since 2008, approximately 6400 Palestinians and 300 Israelis have been killed (not including the deaths since October 7, 2023, which is when Hamas killed and took several Israelis and Americans, resulting in a military response from Israel).

Maternal Mortality

The maternal mortality rate in Palestine is estimated to be 20 per 100,000 live births. The history of Palestinian displacement and oppression has led to negative outcomes in maternal health. The rate of maternal deaths rises during and after every conflict in Gaza--not just as a direct result of the violence, but also due to the overburdening of hospitals and destruction of roads and healthcare facilities. These overburdened maternity facilities often discharge patients too early, which can result in health problems not being monitored properly. 

The blockade on the Gaza Strip also contributes to maternal mortality. Between 2000-2007, approximately 10% of pregnant Palestinians were delayed at Israeli checkpoints, resulting in 69 births occurring at checkpoints, 35 infant deaths, and five maternal deaths. These effects are only exacerbated during periods of increased conflict, as women are more likely to choose home births out of fear of danger outside of their houses. This is problematic because hospital births–where more medical staff and equipment are readily available– are considered significantly safer than at-home births, even when the home birth is accompanied by a healthcare professional. These checkpoints also delay medical supplies and the arrival of ambulances, delaying adequate healthcare delivery. 

The vast majority of these maternal deaths are preventable, but the Israeli occupation makes it difficult for women to safely give birth and for healthcare professionals to do their jobs properly. 

Infant and Child Mortality

As of 2022, the infant mortality rate in Palestine is 13 per 1,000 live births, which is below the global infant mortality rate (27 per 1,000 live births). 92% of infants receive post-birth care from a healthcare professional within two days of delivery. 

For children, however, the mortality rate is significantly high--especially given the recent bombings from Israel. 22% of children in Palestine die before the age of five, which is seven times higher than the child mortality rate in Israel. Furthermore, 40% of the population in Palestine is aged 0-14, and approximately 40% of the people killed in Palestine since October 7, 2023 have been children and infants. These deaths are not just directly due to violence, but also due to Israel’s targeting of water and power networks. Polluted water is a leading cause of child mortality in Gaza, as people are forced to bathe in and drink water contaminated by sewage. 

Sexual Freedom and Family Planning

Misogyny is a large contributor to the lack of sexual freedom in Palestine. In an interview of an OB/GYN from Gaza, she states that “I would never accept an unmarried girl at my clinic…This has nothing to do with freedoms, this is religion. In all religions, adultery is forbidden.” Furthermore, contraceptive use is often controlled by women’s husbands with approximately 41% of women using contraception having their method of contraception chosen by their husband. Abortion is criminalized except for in cases where the woman’s life is at risk--and even then, the woman’s husband has to approve the decision. Furthermore, many Palestinians see having children as defiance towards Israel. This is because Israel has historically feared Palestinian people outnumbering Israeli people, as it “undermines their vision for a Jewish nation-state”. According to Palestinian activist Shams Hanieh and France-based writer Aude Nasr, “Israel’s regular killing of Palestinians, arrests of children, and moving Israeli settlers into Palestinian land are all tools to curb the growth of the Palestinian population and ensure Israeli dominance. This, in turn, has encouraged a view of Palestinian childbirth as a form of resistance against Zionist agendas, in both Israeli and Palestinian national narratives”. 

Conclusion

The misogyny that is prevalent in Palestine and the oppression from Israel has resulted in unfavorable conditions for Palestinian women and children. Given the current violence in Gaza and the West Bank, these issues are only expected to worsen.





Sources

Nikki Mahendru
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