Gaza: Displaced pregnant women at high risk amid dire conditions in Rafah

Grappling with an overwhelming surge in needs and lack of capacity, the Emirati hospital can now only respond to the most urgent and life-threatening deliveries. Doctors Without Borders / Médecins Sans Frontières (MSF) teams are deeply alarmed by the deteriorating lack of obstetric care in Gaza, caused by the continuous bombings, restrictions on humanitarian aid, and attacks on healthcare facilities.

“With so many people displaced, the situation in Rafah is terrifying,” said Doctors Without Borders emergency coordinator in Gaza Pascale Coissard. “All places are overcrowded, with people living in tents, schools, and hospitals. The Emirati hospital is now dealing with three times the number of deliveries it handled before the war.”

The humanitarian crisis unfolding in Gaza has left expectant mothers without medical check-ups for months, as primary healthcare services are virtually unavailable and women in labor are unable to reach hospitals because of the lack of fuel and capacity in the few remaining hospitals. Displaced women living in deplorable conditions are giving birth in plastic tents and public buildings. Those who manage to deliver in a hospital often return to their makeshift shelters mere hours after undergoing a Caesarean section.

To reduce the risk of morbidity and mortality among mothers and newborns, Doctors Without Borders is supporting the Emirati hospital with postpartum care by adding 12 beds to the ward, to reach a 20-bed capacity, allowing more patients to receive proper monitoring post-delivery.

“Without enough supplies and too many patients, the healthcare system is overstretched, and mothers are forced to be discharged just hours after giving birth,” explains Doctors Without Borders midwife activity manager Rita Botelho da Costa. “The first 24 hours postpartum are the riskiest for complications, and with people living in dire conditions, it´s important to keep the patient in the hospital as long as possible.”

With so little access to maternal health services, many pregnant women have not received any care since the start of the war, and haven´t been able to check on the health of their child. 

At six months pregnant, 33-year-old Rana Abu Hameida was admitted to the maternity ward at the Emirati hospital because she was suffering from pregnancy complications. Rana never had an ante-natal checkup since the start of the war. Abu Hameida was displaced from Beit Lahya, in North Gaza, and like Maha, is now sleeping in a tent.

When pregnant women don´t have proper access to healthcare, enough food, or adequate shelter, they and their children are more likely to experience health issues, including infections. The children of malnourished pregnant or breastfeeding women are at immediate risk of health issues and potential long-term developmental challenges.

Over a third of patients seeking antenatal care exhibited anemia, a condition often associated with an iron deficiency, which is a critical concern for pregnant women who often require iron supplementation. Additionally, nearly half of these women had genitourinary infections, such as urinary tract infections.

In Rafah, Doctors Without Borders teams are providing postpartum care as well as mental health support in the Emirati hospital. In Al Shaboura Clinic pregnant women are provided antenatal care including screening for malnutrition and given supplementary therapeutic food if needed.

In the first week of January, Doctors Without Borders gynecologists and obstetricians provided antenatal care to over 200 patients at the Al Shaboura clinic. In the Emirati hospital’s post-natal care ward, within the first week of expanding the ward, Doctors Without Borders teams received over 170 patients. However, without sufficient humanitarian aid to Gaza and protection for the few health facilities that remain functioning, the provision of care will continue to be a drop in the ocean.

Doctors Without Borders reiterates our call for an immediate and unconditional ceasefire, and for the protection of health facilities to safeguard lives. We also stress the urgency to promptly restore the flow of humanitarian aid into Gaza and re-establish the healthcare system, upon which the survival of mothers and children in Gaza critically depends.