As bombs continue to drop over Gaza amid the ongoing Israel-Hamas conflict, thousands of women are facing the prospect of having to give birth in a conflict zone, lacking water, food and access to life-saving medicine, according to medical experts.
Gaza is home to 50,000 pregnant women. Of these, 5,500 are expected to give birth in the coming month. That means around 160 women will give birth every day, the United Nations Population Fund (UNFPA) said in a statement on Monday.
Similar statistics were not available for pregnant people in Israel.
“We know that those women can’t get access to basic maternal health services. They’re facing this double nightmare,” said Dominic Allen, the UNFPA representative for the State of Palestine.
“The health-care system is under attack on the brink of collapse and these pregnant women who continue to give birth every single day are really facing unthinkable challenges.”
Amid the conflict, Allen said the UNFPA is calling for immediate, unobstructed humanitarian access to food, medicines, fuel and water in Gaza, so pregnant women and newborns can receive these essential supplies.
“Pregnant women are not a target and they’re protected under international law,” Allen told Global News. “Humanitarian aid has got to be able to get through… The UN system is ready to respond, it’s got trucks lined up at that border, ready to cross, (but) we can’t get it in. Gazans are running out of time.”
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Israel imposed a “complete siege” on Gaza after Hamas militants fired rockets at Israeli towns on Oct. 7, before breaking through the heavily-fortified border fence, killing over 1,400 people, including civilians and soldiers, and taking roughly 199 others hostage.
In response, Israel said it was “at war” with Hamas, bombing the densely-populated area and cutting off water, power and fuel access in Gaza.
Since the conflict started, humanitarian aid into Gaza has also been blocked. However, on Wednesday, Israel said it will allow Egypt to deliver limited quantities of humanitarian aid to the Gaza Strip.
Health authorities warn that without humanitarian aid, hospitals and emergency services will soon collapse, with backup generators in hospitals having fuel for just another day or two. On Tuesday, hundreds of Palestinians were killed after a blast at a Gaza City hospital.
Hamas blamed Israel for the massive blast at the al-Ahli Hospital — saying nearly 500 died — while Israel blamed a rocket misfired by other Palestinian militants.
“The consequence of not having something as basic as electricity or water means that it impacts the hospitals’ ability to function,” explained Dr. Anna Banerji, a pediatric infectious disease specialist and expert on refugee health at the University of Toronto.
“So you have babies that are being born and maybe there’s no light… or the baby needs resuscitation, or a baby needs to be on a ventilator if born prematurely…those babies are going often suffering. Or if the mother’s hemorrhaging, the mom could die and then the baby could die,” she told Global News.
Giving birth in a warzone
During pregnancy, a mother has significant needs, both for herself and her fetus, said Nadia Akseer, associate scientist with Johns Hopkins Bloomberg Public School of Health. These include nutrition, health care, access to clean water, and protection from violence, abuse and exploitation.
“Unfortunately, all these things fall apart during conflict,” she told Global News.
“The services that she might need to access may not be available to her because health-care workers are busy with others and those services may be suspended. And that often happens in conflict settings. In these cases, sometimes hospitals are blown up and then there’s just no hospital available.”
She explained that stress, coupled with inadequate access to water and food, places significant strain on both the mother and fetus, possibly leading to premature birth or elevated mortality rates.
A 2017 study published in the BMJ Global Health found that pregnant women who are exposed to armed conflict have an increased chance of stillbirth, prematurity and low birth weights for newborns.
The long-term health implications of low birth weight are significant because individuals are at increased risk of morbidity and mortality and will require increased medical care throughout their lives, the researchers stated.
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The impact of inadequate nutrition on a pregnant woman is profound, Akseer said. For instance, she pointed out that in Afghanistan in 2021, during the Taliban’s takeover, the country faced an economic crisis and struggled with a scarcity of accessible food.
“Mothers were showing up at health clinics so severely malnourished that when their babies are born, they were disfigured, they don’t even look like a baby anymore,” she said. “It’s because they’re so malnourished, both the mother and the fetus, that the baby has not grown properly. So deformities of all kinds are showing up in babies.”
Another impact armed conflict has on pregnancy is a lack of life-saving medical tools and medicines, explained Banerji. Without electricity, many hospitals cannot use incubators or ventilators, a necessity for babies born prematurely.
“The consequence of all of this is that babies don’t get enough oxygen to their brain. They either can’t be resuscitated or if they survive, they end up having cerebral palsy,” she said. “So a lot of very bad birth outcomes occur.”
The production and quality of breastmilk are also adversely affected by stress and conflict.
If a mother can’t produce enough breastmilk, Akseer said many are going to supplement with whatever is available, such as tea or dirty water.
“That’s a common thing, giving tea to children and that stunts the growth of the baby. And also dirty water. And why dirty water? Because the water available is dirty,” she said.
— with files from the Associated Press