(NEW YORK) — As the Israel-Hamas conflict continues — with food, water and fuel running out in Gaza — pregnant people and those who have just given birth are facing a crisis, experts and humanitarian organizations said.
About 50,000 people are estimated to be pregnant in Gaza with about 160 estimated to give birth every day, according to the United Nations Population Fund (UNFPA).
Additionally, an estimated 73,000 are pregnant in the West Bank, with more than 8,000 expected to give birth within the next month, the UNFPA said.
Experts said pregnant women and new mothers are facing life-threatening challenges to accessing safe care, putting their health and the health of their babies at risk.
“I think we have to start off with the basic premise, which is that war is bad for health,” Dr. Dabney P. Evans, an associate professor of global health in the Rollins School of Public Health at Emory University, told ABC News. “There’s no good health outcome that is going to come as a result of war and conflict.”
“And then from a public health perspective, we would tend to focus on vulnerable groups and so pregnant women and children … would be among the populations that we would want to pay special attention, to ensure that their health needs are being met,” she said.
Blocked access to care
One of the biggest problems facing pregnant and post-partum people right now is a lack of access to care.
An editorial in The BMJ on the risks pregnant women face in war discussed how there’s no transportation to get someone to a medical center or to a health care provider.
“You have to be able to provide some sort of prenatal care and, generally, that’s gonna be difficult to get them to a clinic unless they have some sort of transportation, depending on the type of zone that you’re in,” Dr. Harry Johnson, an OB/GYN at the University of Maryland Medical Center, who has experience practicing in war zones, told ABC News.
“If you’re house bound, because of the things that are going on around you, you’re not able to get to a health care facility, you don’t have access into to prenatal care, and you don’t have access to the hospital where you deliver the babies,” he continued. “So, you’re pretty much are limited to home care, which is not always adequate.”
This puts pregnant people at risk of having an infant with low birthweight or suffering a premature birth, stillbirth or even miscarriage, experts said.
He added that hospitals also have nurseries to care for newborns so, if someone gives birth at home, there’s no access to health care providers who can keep an eye on the infants’ health.
Even if a patient is able to get to a hospital, the medical center might be overwhelmed due to caring of those who have been injured, have underlying conditions or are even sheltering at the hospital due to losing their homes, experts said.
“There’s more attention, more resources being pooled into acute traumatic events, of injuries that are inflicted by war and in conflict,” Dr. Mimi Niles, an assistant professor at New York University Rory Meyers College of Nursing and a practicing midwife, told ABC News.
She added, “What does that do to the people who are seeking out health care for other reasons? Their lives do not stop when conflict [starts]. People don’t stop being pregnant, right? Or people don’t stop being in labor.”
Risk to safety
Another risk for pregnant people and new mothers’ is their immediate safety due to air strikes and raids.
With a potential ground offensive looming, Israel told more than one million people in northern Gaza last week to flee south to escape the fighting.
The UNFPA shared the testimony of a 30-year-old pregnant woman who been forced to evacuate her home four times, each time with only a small bag of clothes, who said “each time feels like a race against death.”
Pregnant women or those who just gave birth may not be able to move to safety depending on their condition.
“For anyone that has been pregnant, they will know that their doctor would suggest not flying or not traveling far from their local home base as their delivery draws nearer, and for people that are in conflict situations or humanitarian situations, they may not have the ability to control that,” Evans, the director of Emory’s Center for Humanitarian Emergencies, said.
Hospitals may also be at risk of attacks. Israel’s evacuation orders included 22 hospitals treating more than 2,000 patients in northern Gaza.
Experts told ABC News that health care facilities in any conflict zone should be neutral players.
“We’re medical providers, so we can’t really say what’s going on outside the hospital, but we would encourage that, and we would hope that, hospitals are protected and that they’re really safe zones,” Johnson said. “I think medical personnel are really neutral players in conflict zones and what we focus on really is taking care of patients — and in my particular case, would be pregnant women and newborns — and it’s just important that we respect that neutrality.”
Disputed family planning services
While the blockades may be preventing pregnant people and new mothers from accessing care, it’s also affecting access to family planning services.
This means people trapped in conflict zones may not be able to reach their health care providers to receive reproductive health care or have access to contraceptive, taking reproductive choices away from civilians.
“There are people who maybe were scheduled to get routine care or routine contraceptive care and routine abortion care, and they no longer have access to that care, because that clinic is closed or it’s been destroyed or there might be blockades,” said Niles. “These are all things that are part of what we call the reproductive justice framework, making sure that people have access to all the options that help them realize their own full humanity.”
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