Anan Abu Jamaa, 30, a resident of Bani Suheila, east of Khan Younis in southern Gaza, was in her third month of pregnancy when an Israeli aircraft dropped leaflets ordering the evacuation of the area, warning it would become a dangerous combat zone.

Fleeing with her husband, Anan ran more than 2 kilometers until they reached the main road, escaping the death that awaited them if they had stayed, as happened to many of their relatives and neighbors in Bani Suheila.

Their journey on foot towards the west of Khan Younis, heading for the Al-Mawasi area, which the Israeli army designated as safe, was fraught with danger. They couldn’t stop to rest, let alone sit, due to the random bombardment and the risk of being killed, as had happened to other evacuees fleeing their homes.

After four hours of continuous walking, Anan was exhausted and struggling to catch her breath. The road was crowded with thousands of displaced people, and the sound of shells never ceased. She could not stop thinking about her pregnancy and the potential harm the strain could cause.

Anan spent her first night in a tent with relatives. During the night, she experienced vaginal bleeding but had no choice but to stay in bed and wait until morning to go to the hospital, as moving at night in a war-torn city was far too dangerous.

The following morning, Anan arrived at Al-Tahrir Women’s and Maternity Hospital within the Nasser Medical Complex. After hours of waiting, due to the hundreds of pregnant women needing care, she finally made it to the examination room.

The initial examination revealed that the fetus had no heartbeat, and she required an urgent abortion to stop the bleeding and save her life.

“During my second pregnancy, I was displaced more than seven times and didn’t have access to proper nutrition like I did during my first pregnancy, when I could eat fresh meat, fruits, and all kinds of food,” Anan told Daraj.

Anan underwent the abortion at the Nasser Medical Complex. She was the seventh patient that day to undergo an abortion at the hospital.

A Lost Generation

Dr. Ghassan Musallem, head of the obstetrics and gynecology department at the Nasser Medical Complex, confirmed the alarming rise in miscarriages in Gaza, saying the increase was unprecedented in the last 10 years. “Generations are ending before they even begin,” he said, holding data showing the unnatural rise in miscarriage cases.

“Before the war, we handled one or two miscarriages daily, but now we are seeing around seven every day,” Dr. Musallem told Daraj. “In August of last year, we had 35 miscarriages. In August this year alone, we had 127.”

Most miscarriages, Dr. Musallem explained, happen to women who experience heavy shelling near their homes, causing extreme panic and exposure to toxic materials. Miscarriages also occur due to the physical strain of displacement—pregnant women forced to run through streets or walk long distances carrying their belongings, or living in tents under the scorching sun.

Dr. Musallem also attributed the rise in miscarriages to the lack of essential supplements that pregnant women need during their first trimester, along with the absence of basic foods such as fruits, red meat, and vegetables.

“When these essentials are available,” he said, “pregnant women receive only a fraction of what they need—about one-thousandth, which is not enough to fill the nutritional gap.” He added that vital supplements like folic acid, which help sustain pregnancies, are no longer available in Gaza markets.

In March 2023, the Ministry of Health in Gaza reported that around 60,000 pregnant Palestinian women were suffering from malnutrition and dehydration due to the ongoing Israeli assault on the region.

The ministry also noted that women make up 49 percent of Gaza’s population, most of them of childbearing age, and that around 5,000 women give birth each month under extremely unsafe and unhealthy conditions due to continuous shelling and displacement.

Central Gaza

Al-Awda Hospital in the Nuseirat refugee camp in central Gaza is currently the only hospital providing maternal care, including natural deliveries and cesarean sections.

According to Dr. Yasmine, head of the maternal care unit, the hospital has been seeing an increasing number of women with severe bleeding during pregnancy, many requiring emergency abortions.

Dr. Yasmine confirmed that the medical team had documented numerous cases of women losing their babies, experiencing bleeding, or going into premature labor. Many of these cases are linked to malnutrition or anemia, exacerbated by the stress of displacement, which forces people to move from one home to another. “These factors can cause immediate bleeding or high blood pressure in pregnant women, leading to placental abruption and subsequent miscarriages,” Dr. Yasmine explained.

Dr. Yasmine’s department deals with many such cases, as there are many pregnant women who have lost their babies due to being under direct fire.

She also noted that many newborns suffer from low birth weights, which causes oxygen deficiencies or breathing difficulties, often resulting in infections due to poor hygiene or exposure to illness. Most of these infants are transferred to Al-Aqsa Martyrs Hospital for further care. Pregnant women, due to their poor nutrition, often suffer from severe anemia or general weakness, making them unable to endure labor, posing a threat to both their lives and the lives of their babies.

Northern Gaza

Hala Al-Hissi, 25, from the Al-Nasr neighborhood in northern Gaza was two months pregnant when the apartment next to hers was hit by an Israeli missile. She suffered an injury to her right leg, while her husband and son, Ahmad, survived unharmed.

Hala was taken to the Arab Baptist Hospital, where she received first aid before returning home. She and her husband started cleaning their apartment, despite both being injured from shrapnel.

A week after her injury, Hala experienced severe vaginal bleeding and intense pain. With her family displaced to southern Gaza, no one was there to help or understand what was happening to her.

Hala waited more than 12 hours before her husband could take her by horse-drawn cart to Al-Awda Hospital in Tel Al-Zaatar, as there were no cars available.

“I waited for hours before I could enter the examination room because of the hundreds of other women waiting for their turn. After the examination, the doctor determined I needed surgery to remove the fetus,” Hala told Daraj.

Six hours after the procedure, Hala was discharged from the hospital and sent back home, as there were no available beds in the maternity ward due to the overwhelming number of similar cases.

A Surge in Miscarriages

Dr. Yasser Abu Shaaban, head of the obstetrics and gynecology department at Al-Awda Hospital in northern Gaza, confirmed a significant increase in miscarriages due to heavy bombardment, toxic exposure from missiles, and continued displacement.

According to Dr. Abu Shaaban, the hospital, one of only two functioning in northern Gaza, is currently dealing with 100 miscarriages a month during the war, compared to 30 monthly before the conflict began. He emphasized that “Most of these cases involve women suffering from severe bleeding,” requiring urgent medical intervention to save their lives.

During the war, UNRWA health clinics ceased providing pre-natal care services for women, including comprehensive physical examinations, regular checkups, and distribution of essential supplements. Basic contraceptives, including condoms and intrauterine devices (IUDs), also became unavailable.

UN Figures and the Struggles of Menstruation

More than 690,000 women and girls in Gaza are currently of menstruating age, facing limited access to sanitary products, according to the United Nations Population Fund (UNFPA).

The shortage of these products has forced many to improvise using cloth from tents, increasing their risk of infections and other health complications, the UN noted.

According to UNRWA, approximately 80 percent of Gaza’s population has been displaced since October 7, 2023, with many displaced multiple times.

The dire situation is further compounded by the fact that there is only one toilet for every 160 displaced people and one shower for every 700, according to UNRWA, leading to a nightmarish lack of privacy and personal hygiene, exacerbating the rising hunger, thirst, and sleeplessness among the displaced.

UN reports state that no one in Gaza is free from hunger, as access to food remains extremely limited. Women and girls are particularly at risk of malnutrition and dehydration, and the situation is expected to worsen.

Pregnant and breastfeeding women, along with their children, face heightened risks. Some women cannot breastfeed due to malnutrition, and even those who can often lack clean water to prepare formula.

UNICEF, UNRWA, UNFPA, and the World Health Organization have all warned that maternal mortality rates in Gaza are expected to rise, as the psychological toll of the war has direct consequences on reproductive health. This includes an increase in miscarriages due to stress, stillbirths, and premature births.

The World Health Organization also reported that 95 percent of pregnant and breastfeeding women in Gaza suffer from severe food insecurity.

In February 2023, UNICEF warned of the sharp rise in malnutrition among children, pregnant women, and breastfeeding mothers in Gaza, calling it a serious threat to their health, especially as the destructive war continues.

The International Planned Parenthood Federation also noted that more women are miscarrying or going into premature labor due to the shock and stress caused by Israel’s relentless bombardment.