KHAN YOUNIS, Gaza Strip (AP) 鈥� In the ruins of , decimated by Israel鈥檚 18-month-old military campaign, thousands of pregnant women are malnourished. Miscarriages are rising. More babies are born prematurely, some dying because wrecked and overwhelmed hospitals can't care for them.
The and their babies have worsened since March 2, when Israel cut off all food, for Gaza鈥檚 more than 2 million people.
Meat, fruits and vegetables are practically nonexistent. Aid groups are to distribute. Clean water is difficult to find. Pregnant women are among the hundreds of thousands who trudge for miles to find new shelters after repeated . Many live in tents or overcrowded schools amid .
Numbers show the impact
Up to 20% of Gaza鈥檚 estimated 55,000 pregnant women are malnourished, and half face high-risk pregnancies, according to the United Nations Population Fund, or UNFPA.
In February and March, at least 20% of newborns were born prematurely or suffering from complications or malnutrition.
With the population displaced and under bombardment, comprehensive miscarriage and stillbirth figures are impossible to obtain. But records at Khan Younis鈥� Nasser Hospital show miscarriages in January and February were double the same period in 2023.
Dr. Yasmine Shnina, a Doctors Without Borders supervisor of midwives at Nasser Hospital, documented 40 miscarriages a week in recent weeks. She has recorded five women a month dying in childbirth, compared with around two a year before the war.
Multiple risks threaten pregnancies
A U.N. report in March said the blockade and violence were causing harm on an 鈥渦nprecedented scale鈥� to pregnant women and new mothers. It warned of 鈥渋rreversible long-term effects鈥� on Palestinians鈥� mental and reproductive health.
It鈥檚 not just about said Rosalie Bollen, of UNICEF, 鈥渋t鈥檚 also about nutritional diversity, the fact that they have been living in very dire, unsanitary conditions, sleeping on the ground, sleeping in the cold and just being stuck in this permanent state of very toxic stress.鈥�
Only nine of the 14 hospitals providing maternal health services before the war still partially function, according to UNFPA.
Some clinics have shut down or moved because of Israeli military operations. With supplies limited, medical facilities have to prioritize critical cases.
So women often can鈥檛 get screenings that catch problems early in pregnancy, said Katy Brown, of Doctors Without Borders-Spain.
That leads to complications. A quarter of the nearly 130 births a day in February and March required surgical deliveries, UNFPA says.
Complications further strain overwhelmed hospitals
Nasser Hospital has the biggest and best equipped maternity ward in Gaza. Its facilities aren鈥檛 enough.
Over half the medicines for maternal and newborn care have run out, including ones that control bleeding during birth, the Health Ministry says.
Up to 15 premature babies at a time need respirators, but Nasser Hospital has only two CPAP machines to keep preemies breathing. Some are put on adult respirators, often leading to death, said Dr. Ahmed al-Farra, the head of the maternity and pediatrics department.
Twenty CPAP machines languish outside Gaza, barred from entry, along with 54 ultrasounds, nine incubators and midwifery kits, according to the U.N.
Dangerous infections are rampant in mothers after giving birth and in their newborns, al-Farra said. Their immunity is weakened by hunger; hygiene is impossible for lack of cleaning supplies; antibiotics are running low.
Yasmine Zakout was rushed to Nasser Hospital in early April after giving birth prematurely to twin girls. One girl died within days, and her sister died last week, both from sepsis.
Al-Farra said the past 18 months he has treated 50 children with necrotizing pneumonia, a severe infection that kills lung tissue. In half of them, he had to remove part of their lungs. Four died. Before the war, he used to see maybe one case a year.
Israel has leveled much of Gaza with its bombardment and ground offensives, vowing to destroy Hamas after its Oct. 7, 2023, attack on southern Israel. It has killed over 51,000 Palestinians, mostly women and children, according to Gaza鈥檚 Health Ministry, whose count does not distinguish between civilians and combatants.
In the Oct. 7 attack, militants killed about 1,200 people, mostly civilians, and abducted 251. They still hold 59 hostages after most were released in ceasefire deals.
Israel imposed the blockade on March 2, then shattered a two-month ceasefire by resuming military operations March 18. It said both steps aim to pressure Hamas into releasing hostages. Rights groups call the blockade a 鈥渟tarvation tactic鈥� endangering the entire population and a potential war crime.
For one woman, a tragic pregnancy
From the start of her pregnancy last fall, 24-year-old Yasmine Siam struggled to get proper nutrition. She ate mostly canned food. The last time she had meat was on Feb. 28.
With food even scarcer under the blockade, she turned to charity kitchens distributing meals of plain rice or pasta. She was losing weight.
She told The Associated Press of the many stresses wearing at her. Living in a tent camp along with hundreds of thousands of others outside Khan Younis was dirty and uncomfortable. She couldn鈥檛 sleep because of Israeli bombardment. She constantly feared being killed.
She always felt weak. The doctors told her to eat more.
鈥淲here do I get the food?鈥� Siam said.
One night in early April, pain shot through her. She walked to the nearest mobile clinic, then had to take a donkey cart for miles to Nasser Hospital, shaken by the bumpy, bombed-out roads.
Her baby was fine, doctors told her. She had a urinary tract infection and was underweight: 57 kilos (125 pounds), down 6 kilos (13 pounds) from weeks earlier.
Hours later in her tent, she was still in pain despite the medicine they prescribed. She started spotting. Her mother-in-law held her up as they walked to a field hospital.
There, she had an agonizing, eight-hour wait. At 11 a.m. on April 10, her baby boy was stillborn.
Days later, she told the AP she breaks down when she sees photos of herself pregnant. She wishes she could turn back time, even for just a week.
鈥淚 would take him into my heart, hide him and hold on to him.鈥�
Sarah El Deeb, Mohammed Jahjouh And Lee Keath, The Associated Press
