妊娠と小児の健康に関するジャーナル

抽象的な

Delivery in the Time of War: A Study of Births at the Principal Maternity Ward in Benghazi from 2002 - 2013

Zuhir Bodalal, Khalil Agnaeber and Monsef Gnaiber

Background: Al-Jamhouria is the principal maternity hospital in eastern Libya, serving a population approaching two million people. In 2011, armed conflict broke out in Libya which was followed by subsequent civil unrest – placing a heavy strain on the healthcare service. This study aims at performing an observational analysis on the trends of delivery for over a decade while also taking civil unrest into consideration.

Methods: Patient records were gathered retrospectively from the maternity ward for the twelve-year period between 2002 and 2013. The overall number of births and method of delivery were analyzed.

Results: Al-Jamhouria hospital delivered nearly a quarter million deliveries (n=228,598) in slightly over a decade. The majority of deliveries were unassisted vaginal (74%, n=169,199), although as a trend the rate was decreasing. Cesarean sections have more than doubled in the last twelve years with particular increases during the conflict period (in favour of other methods). Intrauterine death rates have been fairly constant in the studied period. Since the start of armed conflict, the number of deliveries at Al-Jamhouria hospital has been declining (for the first time in its recorded history).

Conclusion: Al-Jamhouria hospital has continued to provide healthcare services to pregnant women en masse in eastern Libya – in spite of a myriad of hindrances and a decreasing patient load. Cesarean sections have become more commonplace and their rate has doubled in the last twelve years. The private sector may have potentially helped to relieve the heavy burden on this sole maternity ward. Further studies are needed to determine the short term and long term impact on the health of the population.