Wednesday, November 1, 2006

BAGHDAD — In the face of relentless violence, political chaos, economic uncertainty and nightly curfews, Iraq’s maternity wards are experiencing an unlikely baby boom.

Despite the obstacles, the birthrate in Iraq actually has increased since the U.S.-led invasion 43 months ago, according to the country’s Health Ministry. The rate of births in the country has jumped from 29 births per 1,000 people in 2003 to 37 per 1,000 last year, according to government figures.

In neighboring Iran, the birthrate is half that — 21 per 1,000 population, while the average birthrate in the Middle East is 25, according to the World Bank. The birthrate in the United States is about 14 births per 1,000 people, according to the federal Centers for Disease Control and Prevention.



Thanaa Alladin Mohammed, a doctor who helped compile the statistics, said the Iraqi tradition of large families is primarily responsible for the birthrate.

“People want to have children, regardless of the violence,” she said.

Haithem Ramdam, a 34-year-old engineer and first-time parent, agreed.

“I’m more concerned about the money needed to take care of my family than I am about the security situation,” said Mr. Ramdam, whose child, a girl named Jamani, was born Oct. 2. “This is part of the cycle of life, and you can’t stop it.”

That cycle, Iraqis say, also drives many parents whose children have been killed by war-related violence to produce more.

Fourat Hameed, 29, watched his 3-year-old son, Youseff, die after the taxi they were riding in struck a roadside bomb near Baqouba, 40 miles north of Baghdad, in September 2003. The following year, Mr. Hameed’s wife, Dunai, gave birth to a girl, and in April, they had another son, also named Youseff.

“That boy is a gift from God,” said Mr. Hameed, who noted the importance many Iraqis place on bearing a son to lead the family and carry on its name. “Of course, we can never replace the child we lost, but we wanted a son.”

The Iraqi Health Ministry numbers differ from those in the CIA World Factbook, which notes a slight decline in the birthrate in the years since 2000. Both sources agree, however, that Iraq’s birthrate is far above the regional average, and has remained so despite the war.

As a result of the swelling birthrate in Baghdad’s volatile environment, many physicians here also say they are performing more scheduled Caesarean deliveries than ever.

“Patients cannot always see their doctor or reach a health facility when they need to because of poor security,” said Simone Kurchin, 38, an obstetrician at the Dominican Sisters of St. Catherine of Siena Hospital, a private facility in south Baghdad. “This is always a problem now.”

According to the hospital’s records, Caesarean births have more than doubled since 2003, from 1,107 to 2,447 last year, when they outnumbered natural births.

Iraqi women seeking to give birth in a hospital but unable to afford the $200 fee charged by most private facilities in Baghdad must turn to government-run hospitals. These hospitals, Iraqis say, often lack staff, equipment and medicine.

Sabrya Fahed, whose daughter Kamel delivered her first child at the Al-Wiyah Hospital in east Baghdad on Oct. 4, said giving birth in a Baghdad hospital is more arduous now.

“I gave birth for the last time in this same hospital 11 years ago, and everything was much better then,” said the 43-year-old Mrs. Fahed, who has five children. “Now everything is worse, from the treatment of the staff to the condition of the building.”

And the exodus of doctors — 10,000 since 2003, according to an estimate from the Iraqi Medical Association — has been a serious blow to the quality of the health care system, medical officials said.

Even private hospitals, where doctors’ salaries are up to three times higher than those of their counterparts at government-run facilities, are encountering problems retaining physicians.

The Dominican Sisters of St. Catherine of Siena, the private facility in south Baghdad, has lost six of its 10 obstetricians in the past three years, including Dr. Hana Al-Baea, who had been practicing for 26 months in Iraq before moving to Syria last month.

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