Political fertility in the occupied Palestinian territory: an ethnographic study

Background Although fertility rates in the occupied Palestinian territory (oPt) have fallen, they were still high at 4·5 births per woman in 2009. The high fertility rate has been explained by the importance attributed to the size of the population (political fertility) in the context of the conflict between Israel and the oPt. We assessed how political fertility is perceived by refugee mothers in the West Bank, oPt. Methods We undertook eight semistructured interviews with mothers in the UN Relief and Works Agency for Palestine Refugees in the Near East's (UNRWA) refugee camp Qalandia, West Bank, in 2011. To identify possible political meanings in the West Bank, mothers using reproductive health services were purposively sampled on the basis of the number of their children (one to six) and imprisoned family members (yes or no) to represent the widest possible group of women. We did a content analysis of the empirical material. UNRWA provided ethics approval for the study. All women provided verbal informed consent before participating in the study. Findings Seven of eight mothers gave political reasons for having children, including the Israeli occupation. The mothers feared death or imprisonment of their adolescent sons by the Israeli military. For most mothers, these fears prompted them to have more children to counter such losses; however, some mothers who had sons imprisoned or killed in the conflict had fewer children because of the loss of an income provider and because they were scared of losing another child. Furthermore, mothers who did not think of themselves as being part of a national struggle were having many children. Four of eight mothers brought up infertility and were concerned about its social and political implications. Interpretation Although only eight women were interviewed, their responses give us an idea of the views of Palestinian refugee mothers living in the West Bank. Globally, high fertility rates are often associated with high child mortality rates, which does not seem to be the case in the oPt. Rather, the results of this study show that perceived risks of adolescent imprisonment and mortality affect decisions about fertility. Views of family size were also affected by birth spacing and a preference for sons. We conclude that political fertility in the West Bank does not necessarily mean a higher rate of births and not all fertility is political. Funding Danish International Development Agency (DANIDA).