After a night spent shaking in fear as the roof rattled from explosions, and a long walk along a crowded road, Diana Mahmoud arrived at the hospital where she gave birth to her son, Yaman.
Mahmoud, 22, discovered she was pregnant a week after the outbreak of the war in Gaza and, like other mothers who became pregnant about that time, spent her entire pregnancy fearing for her own safety as well as that of her child. Maternal deaths are three times more likely than before the war, according to a February report by the London School of Hygiene & Tropical Medicine and the Johns Hopkins Center for Humanitarian Health.
“It was not a day or two – no, it was nine months. Every day we lived through it we died a million times because of the bombing and destruction,” says Mahmoud.
The UN estimates more than 5,500 women in Gaza will give birth over the next month. As well as anxiety about safety, the women face practical struggles that come with repeated displacement and a constant search for food and medicine. According to the UN, 95% of pregnant women do not have enough to eat.
The destruction of Gaza’s healthcare system meant that Mahmoud received no antenatal care during her pregnancy and was discharged by the overburdened hospital immediately after Yaman’s birth.
“The situation in the hospitals is so bad, every moment some place or house near you is being targeted so it’s difficult for the hospitals to care for pregnant women. The total focus is on the wounded,” says Mahmoud.
Within 10 days she had to seek medical help again because Yaman’s skin had turned blue and then, while at the al-Aqsa hospital, his heart stopped briefly. The doctors said there had been a problem with his circulation that probably affected his brain but after 10 days of monitoring and testing they released him, saying he was healthy.
Save the Children says 50,000 babies have been born in Gaza over the past nine months, and repeated displacements mean some women are inducing labour themselves because they fear giving birth while on the move.
Israel’s invasion of Gaza, including raids on several hospitals, has destroyed the Palestinian territories’ health system, with very few hospitals able to operate – and the ones that can are struggling with a lack of fuel and medicine. Of Gaza’s 36 hospitals, 13 are partly running and only three are able to support the estimated 180 women giving birth each day. Women are routinely having their babies in tents.
Madeleine McGivern, the humanitarian advocacy adviser at Care International UK, says: “Women are giving birth without any pain relief whatsoever, living in fear, not being able to access any doctor or antenatal care, not knowing whether they’ll give birth in a boiling hot tent or, if they are able to go to a hospital, risk being hit by a bomb or shot by a sniper on the way there or the way back.”
The constant trauma took its toll on Yasmeen Khuwaiter, who found out about her pregnancy two weeks before the war, and gave birth to triplets in April, two months before her due date.
She conceived through IVF treatment after nine years of trying to have a child, but instead of joy she spent the pregnancy in a constant state of anxiety about losing the children. She could not find the medication she needed and was forced to rely on unhealthy processed food which she believes weakened her body and led to several health problems.
When she was in need of treatment in November, she arrived at a hospital to find it closing because of a shortage of medical supplies and electricity. Khuwaiter and her family fled from Gaza City to central Gaza, with her husband having to push her in a wheelchair. Weeks later she had to flee again, to Rafah in the south of the strip.
Doctors referred her for treatment in Egypt, but after a month of waiting to be allowed out of Gaza, the area Khuwaiter was staying in was bombed, forcing the family to flee again to central Gaza, where she gave birth in hospital.
“God blessed me with triplets, a boy and two girls, but they were in poor health due to their premature birth,” she says.
The birth was difficult – Khuwaiter suffered bleeding during the caesarean section, for which she was given some of the very limited stocks of anaesthetic, and one of her daughters spent several days in intensive care. But after two weeks their health improved and the family were discharged.
“We returned to live in a tent. A tent that lacked the necessities of human life,” she says. “You can imagine – three premature babies in need of extreme care, living in a tent.”
• This article was amended on 16 July 2024 to correct the UN’s estimate of the number of women expected to give birth over the next month to 5,500. The 13,000 figure given originally was the total for the West Bank and Gaza.
