Objective: This study describes staffing, caseloads and reported routine practices for
normal childbirth in Palestinian West Bank (WB) governmental maternity facilities
and compares these practices with evidence-based care. Methods: Data on routine
childbirth practices in all eight governmental hospitals were obtained through
interviews with head obstetricians and midwives. Data on staffing and monthly
number of births were collected by phone or personal interview from all 37 WB
hospitals. Results: Forty-eight percent of WB deliveries took place in crowded and
understaffed governmental hospitals. Reported practices were not consistently in
line with evidence-based care. Lack of knowledge and structural barriers were
reasons for this gap. Conclusion: The implications of limiting unnecessary
interventions in the normal birth process are particularly important in a context
of limited access and scarce resources. More skilled birth attendants and a universal
commitment to effective care are neede
