At the beginning of Israel’s invasion of Gaza, the world had its eyes on dozens of premature newborns in the NICU at Al-Shifa hospital. The babies were crowded into the incubators that kept them alive but could fail if the hospital lost power. In the end, thirty-one of the newborns were evacuated, but five died due to “a lack of electricity and fuel,” according to the United Nations. The reason the hospital didn’t have power, of course, was Israel’s blockade of Gaza, which did not permit most food, water, medical supplies, and fuel into the territory. 

As the war enters its fifth month, a slower crisis has been unfolding. The conflict has been particularly cruel to pregnant women and newborns, who are acutely dependent on adequate nutrition, medical assistance, and safe conditions. Around fifty thousand women in Gaza were pregnant at the beginning of the war, and about 180 births occur there every day. As a result of a lack of vital resources, miscarriages and stillbirths have increased, babies are being born prematurely and underweight, and women and children are dying from preventable complications.

The deprivation can be seen at every stage of pregnancy and birth. Pregnant women lack access to prenatal care because most health facilities have abandoned non-urgent visits so they can treat people wounded from the war. Some hospitals have been destroyed by Israeli airstrikes, further reducing capacity. This means that women do not receive the regular health checks needed for conditions like anemia, high blood pressure, and gestational diabetes. These conditions can be deadly for mother and child if left untreated. Deborah Harrington, a doctor working in Al-Aqsa hospital, told the New Yorker that every one of the patients she tested has been severely anemic. “That means they’re more likely to give birth prematurely, they’re more likely to have small-for-gestational-age babies, and they’re more likely to die in childbirth,” she explained. The psychological wounds of being bombed and displaced, of not knowing where your loved ones are or what you will eat next, have surely also taken a toll on maternal health. According to Harrington, 40 percent of pregnant women in Gaza are considered to have high-risk pregnancies.

Delivery is also a harrowing experience. With doctors stretched too thin, women in labor must often give birth without them—in makeshift shelters or in the street, using whatever tools they can find. Those who do make it to a hospital often find that there’s no pain medication, antibiotics, or sterilized equipment. There have been reports of postmortem cesarean sections to save a baby after the mother has died—sometimes from a medical condition, but sometimes after a bombing. 

In the weeks after birth, newborns are at great risk of dehydration, malnutrition, and infectious disease. Breastfeeding is often impossible due to the mother’s malnutrition. Even when formula is available, a lack of clean water means that bottle-feeding could be deadly. Malnutrition at such an early age can result in a lifetime of illness or underdevelopment, and the lack of vaccines and other routine care for newborns puts them at additional risk. 

Humanitarian efforts, like Safe Birth in Palestine, can only do so much. The group, founded by Ferhan Güloğlu, does its best to provide telehealth appointments and instructional videos for pregnant women and their families. It has also tried to send medical kits across the border, but these were arbitrarily held by authorities and aren’t expected to reach women in Gaza for a year. 

Such heroic efforts mitigate the suffering, but the only thing that will finally allow all women and children in Gaza to receive the care they need is for Israel to end its war there. As Güloğlu says, “Birth doesn’t wait. Pain doesn’t wait.”