Miscarriages in Gaza Have Increased 300% Under Israeli Bombing

At Al-Emirati Hospital in Rafah, a woman identified by Doctors Without Borders as Maha sought a delivery room as she began going into labor, but was denied: “All the delivery rooms were full,” an emergency coordinator working with the humanitarian group recounted in a news release published Wednesday. Maha “knew something wasn’t right,” and that she needed care. But without other options, she returned to her tent. Her newborn son died as she gave birth to him in the bathroom near her tent. “Without this war, she would not have lost her son,” the emergency coordinator wrote.

Shortly after Israel’s bombardment of the Gaza Strip began in October, global health groups raised alarms that there was no longer anywhere safe for pregnant women to give birth. More than three months into the siege, conditions have only worsened, and pregnant and menstruating people are especially at risk. Health care workers report a 300% increase in the miscarriage rate among pregnant people in Gaza since Israel’s attacks began three months ago, Nour Beydoun, CARE’s regional advisor on protection and gender in emergencies, told Jezebel.

The lack of supplies due to Israel’s ongoing blockade has resulted in pregnant women struggling to carry healthy pregnancies; higher risk of infection and death after giving birth or having c-sections; increased infant mortality; and a range of other deadly sexual and reproductive health outcomes. Beydoun told Jezebel that CARE has heard about “significant weight loss” among pregnant women “due to the limited access to food, to proper nutrition,” resulting in “poor personal health and also in poor fetal and newborn health.”

Ammal Awadallah, executive director of the Palestinian Family Planning & Protection Association, told Jezebel that “all pregnant women are now at severe risk of delivering in unsafe conditions, being put in situations where they are giving birth in cars, tents, and shelters.” At health centers, pregnant women are only admitted “when fully dilated and are dismissed within a few hours after giving birth, due to the overcrowded facilities and extremely limited resources.” On top of all this, Beydoun said that many women must make the journey to hospitals or health centers—where they could still be turned away due to lack of capacity—on foot.

Due to limited resources, Awadallah says many c-sections and births “are being performed without basic medical supplies, or anesthesia and without any postnatal care.” Few are able to get or attend appointments with their doctors after giving birth, and many “have no option other than to stay in the overcrowded shelters.” As a result, a lot of “women are being dangerously exposed to infections,” the the risk of maternal mortality is high: “There’s now so much risk of hemorrhaging and infections without the right tools and medicines,” Beydoun said. And the many women forced to undergo emergency c-sections also face cesarean wound infections due to lack of clean medical tools for the procedure.

These conditions are similarly dangerous for newborns, who are “dying from a lack of sterile environment and specialized staff,” Beydoun said.

Of course, this is all assuming that pregnant women are able to be admitted into hospitals at all, where “priority is often not for women going into labor” and beds are rarely available for them, Awadallah said. The conditions at the Al-Emirati field hospital in Rafah demonstrate how overworked hospitals in Gaza have become: Beydoun said the hospital was “initially designed to receive 30 to 40 outpatient consultations from pregnant women on a daily basis—now they handle 300 to 400 cases daily.” The hospital has just one operating room and is “designed to have two to three c-section deliveries per day—now they’re delivering 20 daily.”

In October, it was estimated that at least 50,000 women in Gaza were pregnant. The International Planned Parenthood Federation reported at the time that more women were miscarrying or going into early labor from shock and stress under bombardment. And it’s not yet clear how many of those thousands of pregnant women in Gaza are among the estimated 24,000 Palestinians who have been killed in Israel’s attacks, or among the thousands who remain missing. In its charge of genocide against Israel at the International Court of Justice, South Africa alleges that “two mothers are estimated to be killed every hour in Gaza.” (The Israeli death toll from Hamas attacks on October 7 stands at 1,139. Hamas continues to hold roughly 200 people hostage.)

After months of Israeli bombardment, the health care system in Gaza is “completely collapsing,” Doctors Without Borders warned last month. A CNN investigation published on January 12 found at least 20 of 22 hospitals in northern Gaza had been damaged or destroyed in the first two months of Israel’s war on Gaza, and 14 were directly attacked by Israeli forces. The World Health Organization reported in December that no “functional” hospitals remained in northern Gaza, and only nine out of 36 hospitals in the south were even partially functioning to serve Gaza’s population of 2 million. On Tuesday evening, journalists in Gaza reported that Israeli forces had closed in on and were attacking Nasser Hospital.

Birth complications are just one threat people who menstruate are facing: As the independent Gaza-based journalist Bisan Owda highlighted earlier this month, period supplies are nearly impossible to find. According to Awadallah, few people “can find a pharmacy nearby,” let alone one that still stocks sanitary products. Many are forced to use strips of cloth that they can’t wash due to lack of water, plastic bags in lieu of pads, or, “if they’re lucky enough,” cut-up baby diapers. One hospital worker told Owda that “each day” she encounters “numerous instances of fever directly linked to vaginal yeast infections, arising from inadequate hygiene and the absence of feminine products.” Another told her that the “scarcity of basic products results in more hospital visits, longer hospital stays, and worsened conditions” from infection and disease. Severe water shortages and overcrowded public bathrooms further contribute to “the high number of reproductive and urinary tract infections,” Awadallah said.

On top of that, due to “the suffering, anxiety, and deteriorating psychological status of the women in the [Gaza] Strip,” Awadallah said a large proportion are now “getting their period a number of times during the month” instead of once.

This lack of water and malnutrition as a result of Israel’s blockade have been especially detrimental for nursing mothers: Women are struggling to breastfeed their babies as they aren’t able to produce milk “without having water to drink nor sufficient food to eat,” Awadallah said. In a letter provided by CARE, Alaa, a mother in Gaza, wrote that “no one is eating enough,” and “it is usually the mothers who eat last” in order to feed their children first. “I slept on an empty stomach every night so my children wouldn’t go hungry,” Alaa wrote. Back in October, Al-Aqsa Hospital told the Associated Press that many mothers in Gaza were forced to mix baby formula with contaminated water, “[contributing] to the rise in critical cases” in the hospital’s neonatal ward.

Barriers to basic health care and resources aren’t new for the women and girls of Gaza, Awadallah told Jezebel: “Palestinian women and girls were already living in a severely vulnerable environment, in an area which has been blockaded from essential basic health services and products for more than a decade.” But the crisis has become more dire than ever, and “without a full and immediate ceasefire, and the unimpeded delivery of humanitarian aid across all parts of Gaza, maternal and neonatal deaths will continue to rise.”