“Every pregnancy these days is a struggle”: Restoring life-saving healthcare in Gaza

GAZA STRIP, Occupied Palestinian Territory – Two weeks into her ninth month of pregnancy, Roozan Abu Jbarah hoped she would manage to give birth safely. “I’ve been having pain and my water broke,” she told UNFPA, the United Nations sexual and reproductive health agency. “What I’m most concerned about is the baby’s health, because the basic things haven’t been available.”

Currently living in Nuseirat, in the Deir-al-Balah Governorate, the 23-year-old had endured a harsh pregnancy under Israel’s assault on Gaza and the lack of critical supplies allowed into the territory over the past 16 months. With some 70 per cent of infrastructure heavily damaged or destroyed, the health system lies in ruins. Transport options are severely limited and the costs unaffordable for most, leaving women with little or no access to essential maternal and reproductive healthcare. 

“The first four months were difficult because of morning sickness, and there was nothing available to ease it,” Ms. Jbarah explained. “No treatment, no fruits – even the medicine that usually helps wasn’t available.”

Despite the fragile ceasefire, an estimated 155,000 pregnant women and new mothers in Gaza face dire conditions, struggling to survive in tents and makeshift shelters, exposed to harsh weather and biting winds. Without clean water and sanitation, their weakened immune systems are yet more vulnerable to disease and ill health. And although recent upticks in aid have eased some immediate health threats, displacement, sparing food costs and financial hardship mean hunger, malnutrition and illness are still widespread.

“There was no food other than duqqa (a spice mix). Even milk wasn’t available – no pasteurized milk, no powdered milk. I tried to replace what I could with supplements, although they were hard to find,” added Ms. Jbarah. “At the health centre they gave me just two packs of [anti-nausea] medicine, which I had to make last a long time.”

Healthcare under fire

Since the start of the war in Gaza, UNFPA has provided antibiotics and essential medicines for pregnancy, childbirth, and managing conditions such as postpartum bleeding and other life-threatening complications. Incubators, ultrasounds, surgical tools, syringes and equipment for operations – including deliveries, Caesarean sections and blood transfusions – have been distributed to facilities and partner organizations across the territory. 

To ensure emergency obstetric and newborn care reaches even areas hardest to access, UNFPA has deployed six mobile maternity units staffed by specialized health workers. And hundreds of UNFPA-supported midwives and health teams are working in temporary shelters to meet the needs of displaced people in dire need of care. 

Hadeel Abed, 23, is also currently in Nuseirat with her five-year-old daughter, and was seeking a check-up at Al Awda Hospital. Ms. Abed described the effects the war is having on the women around her. “Giving birth under these conditions is not feasible,” she said. “Every pregnancy these days is a struggle, with illness, fatigue and malnutrition.”

Compounded by widespread uncertainty and loss, the psychological toll has further deepened people’s vulnerabilities, increasing the risks of life-threatening pregnancy and childbirth complications. “Many times, miscarriage happens in the fifth month,” added Ms. Abed. 

UNFPA is providing mental health support to help women cope with the trauma of war, ensuring they receive both the medical and psychological care they desperately need.

Funds needed to rebuild life-saving care

Since the ceasefire, UNFPA has set up medical tents at damaged hospitals and health facilities, deployed over 70 midwives to ensure the continuity of essential maternal and reproductive healthcare, and is helping to restore Al Khayr Maternity Hospital in Gaza city as well as other primary health centres. 

This support has so far reached 170,000 women and girls with supplies, equipment and medicine, medical treatment and counselling to following sexual violence, as well as essential shelter, blankets and sanitation products.

Yet some 50,000 pregnant and displaced women still urgently need support to give birth safely – which is now in greater jeopardy with the latest blockade of humanitarian aid by Israeli forces and an uncertain funding outlook. As one woman in the Jabalia refugee camp explained, “War becomes two wars when it affects a woman – she suffers in all aspects: The bitterness of war, the bitterness of loss, and the bitterness of meeting her needs as a woman.”

UNFPA is appealing for $99.2 million to support the rehabilitation of damaged hospitals and health centres, deploy mobile health teams to reach displaced and underserved women, and expand women and girls’ safe spaces and shelters. 

“While the situation is appalling, doctors, nurses, midwives and even cleaners are working tirelessly to provide at least some sense of dignity,” said Laila Baker, UNFPA Regional Director for the Arab States. “We hope that as the ceasefire holds, we will be able to begin rebuilding the health system they depend on.”