Gaza’s Pregnant Women Face ‘Constant Risk of Preventable Death,’ Rights Group Warns

Pregnant women in Gaza are enduring dire conditions as Israel and Hamas’s 15-month war has brought the region’s healthcare system to the brink of collapse. While the ceasefire has brought some relief to Palestinians and Israelis alike, with hostage and prisoner releases on both sides, human rights advocates caution that the urgent need to rebuild Gaza’s shattered healthcare infrastructure may be overlooked.

According to a new report from Human Rights Watch (HRW) released Tuesday, many women are being forced to give birth without access to basic medical care, clean water, food, or sanitation. 

“We have absolutely no idea how many pregnant women have died, how many women right after giving birth have died, and how many newborns have died,” said Belkis Wille, associate crisis and conflict director at HRW.

“The ceasefire, and the provisions of the ceasefire as they currently stand, don't relieve any of the issues that we document in the report,” Wille added.

The 50-page report includes interviews with 17 Palestinian women and reveals a long-brewing healthcare crisis where few, if any, pregnant women have regular access to prenatal, postpartum, or newborn care.

Amid a deepening healthcare crisis, the three-stage ceasefire initiated on January 19 faces a serious challenge following Israel’s ban on the United Nations Relief and Works Agency (UNRWA), which took effect Thursday. The ban, driven by two laws passed in October, blocks the agency from operating in Gaza, East Jerusalem, and the West Bank, jeopardizing the ceasefire’s goal of rebuilding Gaza. Since its founding in 1949, UNRWA has been a critical lifeline for Palestinians in Gaza, providing humanitarian aid and healthcare in the region.

The World Health Organization’s (WHO) director general on Thursday urged Israel to reverse the ban, highlighting concerns about the deteriorating humanitarian situation, particularly for vulnerable populations like pregnant women and child amputees, who already face severe challenges accessing basic healthcare under the existing blockade.

As of January 14, emergency obstetric and newborn care is available at just seven of Gaza’s 18 partially functioning hospitals, four of 11 field hospitals, and one community health center. Before hostilities began on October 7, 2023, there were 20 hospitals and smaller healthcare facilities operating, according to a United Nations report.

Reliable data on newborn survival rates and maternal complications—severe morbidities, deaths during pregnancy, childbirth, or postpartum—remains scarce. But maternal health experts warn that since October 7, 2023, miscarriages in Gaza have surged by up to 300 percent. Gaza’s maternal healthcare crisis has worsened due to strict evacuation and aid restrictions, with pregnancy complications rarely qualifying women for medical evacuation. Since the start of the war, 5,383 patients have been evacuated out of over 12,000 in need, mostly within the first seven months before the Rafah crossing closed, according to the WHO. No data is currently available on how many of these evacuations were related to pregnancy complications.

Shaima, a midwife at al-Sahaba Hospital in northern Gaza, regularly witnesses postpartum hemorrhage — the leading cause of maternal death — as women give birth in homes and tents before being urgently rushed to the hospital. Her testimony in November 2024, documented by Project HOPE, highlights the critical healthcare challenges facing pregnant women in the region.

“This week, a woman came into the hospital with a baby stuck in her birth canal. The baby’s head was out for half an hour. The baby later died… we will continue to see more people die unless there is better healthcare access,” said Shaima.

Multiple waves of displacement since the start of hostilities have also made it challenging to establish networks of informal healthcare that help track maternal and infant deaths in crisis zones. In many conflict situations, especially in mass displacement crises, informal volunteer networks are often formed with the help of local and international organizations. These networks rely on community members who take responsibility for ensuring patient’s needs are met, including medical care and evacuation when necessary, helping to prevent overlooked injuries or fatalities.

However, in Gaza, due to repeated displacement, “it has been impossible to establish these networks,” said Willie, as people are constantly moving from one camp to another before they can build connections. “They and their newborns are at constant risk of preventable death,” she added.

Meanwhile, doctors in Gaza are advocating for a centralized process for medical evacuations with clear guidelines.

“Under this ceasefire agreement, there is supposed to be a mechanism in place for medical evacuations. We’ve still not seen that process spelled out,” Thaer Ahmad, an emergency room doctor from Chicago who worked in Gaza in January 2024, told Reuters on Thursday.

Human rights advocates highlighted the importance of the UNRWA maintaining access to the region if Israel intends to honor the part of the ceasefire agreement related to rebuilding Gaza. However, two bills passed by the Israeli Knesset in October, which took effect on Tuesday, could jeopardize those agreements.

Rights advocates argue the ceasefire should be an opportunity to provide critical healthcare, especially for women enduring pregnancy without medical support — instead, the situation may deteriorate further.