15 November 2023 - With the forced closure of Gaza’s largest hospital, Al Quds, due to the lack of fuel and incessant Israeli bombardment, and the recent storming of al-Shifa Hospital by Israeli forces, midwives are a lifeline for the estimated 180 women who are giving birth each day.
As of 13 November, all but one of the hospitals in Gaza City and northern Gaza are reportedly out of service due to lack of power, medical consumables, oxygen, food and water, compounded by bombardments and fighting in their vicinities, according to OCHA.
26 year old Narmeen Al Shafee is a midwife currently living in Deir al-Balah in central Gaza, who has previously worked with the Palestinian Family Planning and Protection Association (PFPPA) outreach team. She describes the case of a 29-year-old pregnant woman who fled along with her family from Sheikh Radwan to Deir al-Balah to seek refuge in a school shelter near her home. The women was in her ninth month of pregnancy and not long after being displaced from her home she underwent a cesarean section.
Midwife Al Shafee said:
“After giving birth, and for her own safety, the shelters did not want to accommodate her due to the widespread infectious diseases and [the] high risk of infection since she had a cesarean section. Her husband was calling out in the streets for someone to receive his wife and three children. My parents welcomed them into our home to take care of her. I would change her bandages daily and monitor her and her child. After ten days, I removed the stitches. Thank God, her condition is now stable, and there are no problems.”
In a separate case, Al Shafee describes caring for her 23-year-old cousin who was pregnant for the first time and lost her husband early in the war.
“Her delivery date was approaching, and she gave birth at Nasser Hospital in Khan Younis [in southern Gaza]. Her child faced complications during birth, and due to the bombings she sought refuge with us. I took care of her and her child until their situation stabilized. Now, I am helping her with breastfeeding, as she is finding it difficult.”
“I’ve been in contact with two pregnant women multiple times, providing weekly consultations. One woman experienced severe cramps, and after offering advice, she was referred to the hospital. She needed lung maturation injections for the fetus, along with rest and nutritional supplements and iron. Another woman, 29 weeks pregnant, suffered dizziness and vomiting and she took Ancozine [an antiemetic] for nausea during the visit. I also found out that she was taking iron and provided her with information on the correct way to take iron tablets in order for her to benefit from them as needed. I am also providing information to women in my area and around me hoping that it will help them if and when needed.”
According to data from the UNFPA, there are an estimated 50,000 pregnant women in Gaza, with 15% expected to encounter complications. In many instances women are only admitted to hospital when they are fully dilated, with some forced to deliver their babies in cars, in the streets, and in overcrowded shelters where the risk of infection and the spread of disease is high. There are reports of c-sections bring performed without anesthesia, and there is currently no type of post natal care available in Gaza.
Levels of early labor and miscarriages are expected to increase with the trauma and conditions being faced.
Al Ahli Hospital, in Gaza City, which currently accommodates over 500 patients, is reportedly the sole medical facility able to receive patients, amid increasing shortages and challenges. In Shifa hospital, 32 patients, including three premature babies, have reportedly died since 11 November, following the power cut and amid dire conditions.
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.
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Established in Jerusalem in 1964, the Palestinian Family Planning and Protection Association (PFPPA) is locally registered as an independent, non-profit and non-governmental association with headquarters in Jerusalem. PFPPA has service delivery points located in the West Bank Areas of Ramallah, Bethlehem, Hebron and Halhoul, in addition to one in the Gaza Strip, which has yet to be relocated after it was destroyed following an Israeli airstrike on 8 October. Furthermore, and in cooperation with local partners, PFPPA is also responsible for 3 safe spaces to provide Gender Based Violence (GBV) related services in the Jerusalem area.
About the International Planned Parenthood Federation
IPPF, through its 149 Member Associations and collaborative partners, delivers high-quality sexual and reproductive healthcare and helps advance sexual and reproductive rights, especially for marginalized people with diverse needs that are currently unmet. IPPF's Member Associations and partners are locally owned, independent organisations, which means the support and care they provide are informed by local expertise and context.
IPPF advocates for a world where people have the information they need to make informed decisions about their sexual and reproductive health and their bodies. We stand up and fight for sexual and reproductive rights and against those who seek to deny people their human right to bodily autonomy and sexual and reproductive freedom. We deliver care rooted in rights, respect, and dignity for all - no matter what.
Banner image: Midwife Narmeen Al Shafee provides care to a newborn baby in Deir al-Balah, in central Gaza.