Obstetric violence: An overlooked tool of genocide in Gaza

As the year draws to a close, pregnant women and newborn babies in Gaza continue to endure unimaginable hardships and are living under constant threat of violence and killings. The Israeli relentless attacks are destroying all means of life—leaving the population without adequate access to food, clean water, health and security. Amnesty International concluded in a new report compiling evidence since the deadly Hamas-led attacks on October 7th that Israel is committing genocide, with intent to destroy the Palestinian population in Gaza. Obstetric violence, encompassing all forms of harm and maltreatment during pregnancy, delivery, and the postpartum period, is part of the destruction.  

Our partners continue to support pregnant and breastfeeding women in the most dare situations and continue to report horrific stories of pain, fear and trauma: 

“I delivered during the war by caesarean section and my situation was difficult. I was not anesthetized during the birth, and I was in a lot of pain from the needles and stitches. Where are women’s rights? Where are human rights? I got sick after giving birth and was admitted to the hospital again. I also sell the canned food that I receive as aid to buy diapers and milk for my child.”

“I have been forced to flee and live in a tent on the street. I’m nine months pregnant and it’s my firstborn. But I don’t want to give birth because I can’t meet my baby’s basic needs, like clothes and a clean place. I hope to find a safe shelter for my child so that I can protect him from the cold.”

During the year we have highlighted how the conditions imposed on Gaza have had a disastrous impact on pregnant and breastfeeding women and newborn babies, reminding Israel and the international community of the obligations under the Genocide Convention to desist from imposing measures intended to prevent births of a group. This is something that South Africa’s case to the International Court of Justice, ICJ, also highlighted.  

The consequences of Israel’s bombing of hospitals, including maternity care centres, the malnutrition and other negative health consequences and the stress and fear among pregnant women is all contributing to a massive increase of miscarriages by 300 percent.  

“I was 3-month pregnant and had a bleeding since October out of fear due to the heavy fire belts that hit our area. I could not do a checkup as there were no doctors around and for not being able to reach any health center due to the dangerous situation. One day after arriving to the south, I went for a checkup, but the doctor told me that I had miscarried due to intense fear and fatigue as while evacuating, I carried heavy bags: one on my back and the other on my chest as my children were too young to help me. I cried a lot as I waited so long to get pregnant.”

“Because of the lack of available transportation and the delayed arrival of the ambulance, I gave birth on the road and reached the hospital only after my baby was born, endangering both our lives.”

Newborns, pregnant and breastfeeding women are the most vulnerable to malnutrition which is extremely worrying as the starvation is spreading and the lack of food and clean water is acute. Already months ago, UNICEF found that 90 percent of children under the age of 2 and 95 percent of pregnant and breastfeeding women face severe food poverty. 

“I suffered from malnutrition and did not receive the four-month progesterone injection to stabilize the pregnancy. I also experienced severe bleeding due to anxiety and fear caused by the relentless Israeli bombings. My daughter, who was born during the war, now suffers from failure to thrive and malnutrition, as infant formula and nutritional supplements for children are not available.”

The obstetric violence will have long-standing generational impacts. For the individual child and the woman as well as for their families and communities, and the society at large as it impacts the population level, level of education, family structures and the psychological wellbeing of the people. It targets the very core of the Palestinian people by dismantling their social fabric and dignity, systematically eroding their ability to engage in an inclusive and democratic state-building process.  

Amnesty’s report came after several warnings from ICJ, ICC and different UN actors of war crimes and warnings that the threshold for genocide could have been met.  

Governments who despite all evidence of these crimes continue to export weapons to Israel are violating their obligation to prevent a genocide and are at risk of becoming complicit. The international community must act decisively to halt Israel’s ongoing campaign to destroy the Palestinian population. The pursuit of justice and accountability for crimes under international law must be a priority, with investigations and fact-finding missions, including addressing how pregnant and postpartum women have been affected.   

Recommendations to Israel and the international community: 

• We call on Israel for an immediate and sustained ceasefire, to stop the genocide and to ensure humanitarian access across Gaza. We call in the international community to put all efforts into a diplomatic sustainable solution for peace, with an end of the occupation and the creation of a state for Palestinians. 
• We echo Amnesty international’s call on the ICC to “urgently consider the commission of the crime of genocide by Israeli officials since 7 October 2023 in the ongoing investigation into the situation in the State of Palestine.”  
• We urge relevant actors to conduct impartial, independent investigations to determine criminal responsibility under international law. These investigations must include obstetric violence, to determine its role in the ongoing genocide and to ensure justice for those exposed to this form of violence. 
• We urge relevant actors to conduct research to increase the understanding of obstetric violence and its consequences for the affected individuals, their communities and society at large. This understanding is important to inform decisions and ensure adequate responses.  

We urge donors to: 

• Prioritise support to healthcare professionals, services and hospitals. 
• support organisations who are providing supplies and support to pregnant women and birthing persons as well as breastfeeding women. They require comprehensive health services and to be able to live in safe shelters with adequate resources. Nutrition, hygiene materials and hygienic living conditions, vaccines and medicines, health care services for babies and infants are vital. 
• support local women’s organisations who are experts and know the needs. They have been giving support to women and children for decades and have done an extremely important work during this year.  
• respond to the increasing need of trauma and psychosocial assistance.

Footnote: All quotes in the statements are shared to us by partners and women’s organisations in Gaza. For more information please also read Women’s Affairs Center, Gaza (WAC) research paper on: Reality of Pregnant and Postpartum Women During the War on Gaza (2023-2024) “Difficulties, Challenges, and Development Needs” 

—The Kvinna till Kvinna Foundation