Pregnancy Does Not Stop During Crisis
Note: The author would like to strongly acknowledge that women are not the only people capable of becoming pregnant, however, within the context of the article, the word “women” will be used to represent pregnant people because it is most relevant and it is the unique experiences of women that are the focus.
Although pregnancy does not just stop during a war, women's health is not given priority in a conflict zone. Access to prenatal and postpartum medical care, as well as an understanding and respect for the physical toll pregnancy takes on a woman's body, are necessary for a safe pregnancy. Those needs to be respected and taken care of are much more difficult in a warzone. During a crisis, women and children are the most victimized, as existing vulnerabilities to violence and lack of resources are exacerbated by extreme circumstances. Pregnant women occupy a particularly dangerous intersection between physical risk and gender-based violence. When all resources and attention are focused on war-related violence, pregnant women’s care and well-being are pushed aside, leading to higher rates of miscarriage, disease and infection, and death. Pregnancy is stressful and dangerous even in the best of times, but pregnant women in war zones are forced to experience not only extreme physical distress but unique mental anguish as well.
On October 7th, Hamas, a militant group centered around Palestinian liberation in Gaza, attacked Israel, killing 1,400 people and taking 239 hostages. Many people were forced to evacuate their homes, schools shut down, the economy has drastically slowed, and several border communities are living under threat of continued attacks. Citizens urge the government to work on bringing home the hostages, however, talks have stalled over fuel deliveries to Gaza and the Israeli government’s focus on retaliation. The response has been the ongoing siege and blockade of electricity, water, fuel, medical supplies, and wifi to Gaza coupled with over 430 air raids of the 141 square mile area. The fighting between Hamas and the Israeli army has now lasted over five weeks, with the Gaza Strip being the center of violent conflict from bombs and ground invasions. Before the war began, around 100 trucks carrying vital resources were allowed into Gaza daily to support the bare minimum of the population’s needs, however since the Israeli-imposed siege began, only 20 trucks have been permitted to enter. While over 200 trucks wait at the Egyptian side of the Rafah crossing full of life-saving supplies, the Israeli government has only allowed this minimal aid to reach the citizens of Gaza, despite urging from international governments and the United Nations. Buildings, hospitals, places of worship, and homes have been leveled with hundreds dying every day from the bombings. As of writing this, the death toll for Gaza stands at over 11,000, with the majority being women and children. For pregnant women in this ongoing conflict, there is an enormous extra burden and risk. However, the experience greatly differs depending on whether a woman resides in Gaza or Israel.
Access to Medical Care
While pre and post-natal medical care has made enormous leaps in improving the safety of pregnancy and birth, there are still major problems with access to this vital care. Being pregnant in Palestine, particularly the Gaza Strip has never been easy. There is limited access to healthcare resources, vital medicines, trained staff, and reproductive and perinatal care. Currently, there are an estimated 50,000 pregnant women in the Gaza Strip, with over 160 births per day. The vast majority have no access to the care they need due to the ongoing fighting. Conflict combined with a lack of available care puts enormous stress on expecting mothers and causes an increase in miscarriage, premature birth, and pregnancy complications. Moreover, according to Care International, It is reported that pregnant women are being forced to undergo emergency C-sections without anesthetics. Due to the lack of capacity in hospitals and medical supplies, healthcare workers in Gaza are discharging new mothers three hours after surgery. "We are also hearing that some hospitals have run out of baby formula. This is particularly concerning because trauma can affect a mother’s ability to produce milk. As food supplies dwindle, there is a substantial risk to the health of the 283,000 children under five and pregnant or lactating women” concluded Hiba Tibi, CARE West Bank and Gaza Country Director. These circumstances foreshadow a significant increase in maternal and newborn mortality rates anticipated in the coming weeks.
Furthermore, within the remaining “functioning” hospitals, pregnancy and birth often do not take priority, although there have been efforts to direct remaining fuel and electricity to neonatal units in Gaza. Basic hygiene standards and sterility are difficult to ensure due to the sheer number of victims and lack of clean running water, meaning disease and infection are rampant. The act itself of leaving home to go to a medical facility is dangerous due to the shelling, and once in a hospital, there is no guarantee of safety. There have been a reported 72 attacks on medical personnel by the Israeli military, despite that constituting a war crime in the eyes of international law. As over 30 hospitals within Gaza have closed due to lack of resources, overwhelmed personnel, and constant destruction, women are forced to remain at home for birth. Over 37,000 women will be forced to give birth without any access to electricity or medical care in the coming weeks and months. Palestine’s Family Planning and Protection Association (PFPPA) is being stretched unimaginably thin. From one woman serving on the ground in Gaza, “I have received calls from women having a miscarriage due to the bombings and gas, another going into labor, neighbors reaching out for help… all of which I am trying to assist but with such limited options and resources available and accessible.. I am afraid for their well-being and even for their lives.”
While the stress of being at war affects women in both Israel and Gaza, Israeli women still have access to the medical care they need. Israel is ranked the 6th best healthcare system in the world with state-of-the-art equipment facilities and treatments. Additionally, Israeli women are not subjected to the same lack of basic needs such as electricity, water, food, and fuel. In both Israel and Gaza, there is the constant threat of air raids and pregnant women have to be ready to flee to take cover at any moment. Bomb shelters have been a feature of almost every Israeli household starting from the 1990s and most are well equipped with resources, such as medical supplies and food to last several days if needed. Access to healthcare, a safe place to reside, and basic resources throughout pregnancy in Israel have remained largely the same since the beginning of the war with Hamas. However, in Gaza, the situation for pregnant women grows more desperate and dangerous by the hour while bomb shelters do not exist.
Physical Toll and Evacuations
In addition to the increasingly limited access to medical care for pregnant women in Gaza, forced evacuation is another major concern. It is common practice during pregnancy, especially in the later months, to limit physical exertion and the stress of movement for the body. Respecting the physical toll that pregnancy has on a woman’s body is important for the safety of both mother and child. However, Israel’s evacuation order for the north of Gaza, affecting half of the population of over 2 million has made this vital rest impossible. Before the order, women were already on high alert for bombings. This order in preparation for a ground invasion requires pregnant women to increase the physical stress on their bodies alongside the mental and emotional toll of having to evacuate and abandon their homes. This order has been considered a “race against death” and has been widely criticized by humanitarian groups. The executive director of the United Nations Population Fund released a statement against the evacuation order, stating: “For the thousands of women about to give birth, and those who are sick and critically injured, being forced from their homes with nowhere safe to go and no food or water, is extremely dangerous.”
After the first attacks on October 7th, many Israelis left the areas surrounding the Gaza Strip. An estimated 200,000 Israelis have been internally displaced with the Israeli government providing hotel rooms and services to those affected. Many Israelis have also fled the country, with large concentrations in Cyprus and surrounding countries. While there is no specific data yet on the amount of pregnant women within those numbers, their freedom to relocate is key. Leaving Israel is a decision that Israeli women can choose or choose not to make, while women in Gaza are forced to evacuate their homes without a concrete plan or adequate transportation. There are only a few camps and centers taking in refugees, and those that have been set up with help from international organizations are overwhelmed and under-resourced, if not bombed.
The Disparity
Pregnant women in both Israel and Gaza have been forced into extreme circumstances due to this crisis. The situation is dangerous, volatile, and unmanageable as tensions in the region escalate. However, in this conflict, Israeli women largely have access to the medical care and resources they deserve, while Gaza is one of the most dangerous places in the world to be pregnant. The reason for the disparity between available care is a direct result of Israeli domination of the Palestinian territories and the intentional weakening of services and infrastructure in Gaza for decades. This put Gazan women in a vulnerable position prior to the war; one that has only worsened due to the current bombings, destruction, and siege of resources by the Israeli military. Israeli women have the freedom of relocation, access to bomb shelters, and an equipped government to provide emergency aid when needed. In Gaza, pregnant women are forced to evacuate into dangerous and uncertain areas, where adequate rest, care, and humanitarian aid are not available.
Women in both Israel and Gaza are under enormous new pressures that will negatively affect their experiences with pregnancy and birth. According to a study conducted by the National Library of Medicine, there is an overall “[...] increase in the incidence of miscarriage, stillbirth, prematurity, congenital abnormalities, miscarriage and premature rupture of membranes among mothers exposed to armed conflict”. All of these concerns fall upon the mother alongside the fear for her own survival. However, it is pregnant women in Gaza who have to suffer a lack of medical care, forced evacuations, constant community death, and lack of access to basic resources. The disparity between their realities exposes not only the profound crisis that decades of Israeli resource blockades have created but also the severe and urgent humanitarian need. Pregnant women in Gaza do not have time to wait for lengthy peace talks and political deals, they are suffering now and the situation is growing more dire by the hour.
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About the author:
Natalie Alper is an American Jew who works with the the New York Immigration Coalition. She has a degree in International Studies from Saint Louis University and has lived in Uruguay, Spain and Jordan throughout her academic career. She is passionate about women's rights and empowerment, and is proud to serve Politics4Her as a Feminism Movement and Partnership Facilitator.
