The Electronic Intifada 26 December 2024
A pregnant woman is seen by a nurse in a medical tent in a shelter in Gaza in August.
ZUMA PressOn 7 October, Fadwa al-Hassani, 31, went into labor.
A year into Israel’s genocide in Gaza, she and her family were trapped in their home in the al-Shaboura area of Rafah refugee camp, however, which was besieged by the Israeli military.
“It was just before midnight when I started feeling labor pains,” Fadwa told The Electronic Intifada.
Communications were haphazard, however. Her husband, Yusuf, 34, tried to call an ambulance, but he couldn’t get through to anyone.
Braving the streets was also risky.
“The occupation forces were targeting anyone or any vehicle moving inside the camp,” Fadwa said.
She and her family – Yusuf and three children – had no choice but to stay in their home, unable to reach the hospital due to heavy bombardment in the area and the close proximity of Israeli tanks.
So they called on a local traditional midwife, Aysha, to help with a birth that would eventually go deep into the early morning hours.
The use of traditional methods of childbirth has become increasingly common in Gaza where, as far back as April, the International Rescue Committee (IRC) reported that most of the 183 women who on average give birth daily in Gaza lack access to trained midwives, doctors or healthcare facilities as a result of Israel’s genocidal violence.
Hunger is also a critical issue, with 155,000 pregnant and breastfeeding women at “high risk” of malnutrition.
Anxiety and malnutrition are critical risk factors for pregnant women in Gaza, Nestor Owomuhangi, the United Nations Population Fund’s representative for Palestine, said In October, with thousands of pregnant women on “the verge of famine” and “in famine-like conditions”.
The traditional way
Aysha lived just minutes away from the al-Hassani home and it was to her that Fadwa’s husband turned.
She came with nothing. She had already asked Yusuf to provide “a pair of scissors, a clothes peg, some salt, and a piece of cloth,” Fadwa said.
Once baby Hamza started coming, Aysha got a firm grip of his head and pulled him “forcefully,” in Fadwa’s telling, from the womb. She used the scissors to cut the umbilical cord, salt on the resulting wound, the clothes peg to close the newborn’s navel and wrapped Hamza in the cloth.
She asked Fadwa to keep changing the salt on Hamza’s belly button in order for the cut to heal cleanly. These methods worked and Hamza was fine.
But, by four days later, Fadwa’s womb and pelvic area were badly infected.
“I felt intense heat in my body. My husband called the ambulance again, but they said our area was dangerous and difficult to access.”
Instead they advised Yusuf to bring Fadwa on foot by heading west, where an ambulance would wait. It was about a kilometer away, and Fadwa was in great pain, but they made it.
The ambulance took them to the Emirati Red Crescent hospital where she wound up spending three weeks due to an infection that had caused postpartum fever.
Risks
The turn to traditional methods of childbirth is hardly surprising in a place where hospitals – or what hospitals are still able to function – are running at three times capacity. But it carries risks, especially under the circumstances.
With Israel having cut running water to Gaza, the lack of access to clean water is one of the greatest causes of infections and complications, said Dr. Ahmed al-Banna, a specialist in obstetrics, gynecology and infertility, formerly with al-Shifa Hospital.
“Many have had to give birth at home or in shelters, in the absence of proper hygiene, which exposes the mother and baby to dangers such as severe bleeding, infections and viral and bacterial diseases,” Dr al-Banna told The Electronic Intifada.
The use of the traditional midwife’s rudimentary tools also marks a “regression in providing safe medical services,” he said.
Hadeel Qadeh, 23, from Khuzaa, east of Khan Younis in the southern Gaza Strip, went into premature labor in July, after a period of intense bombings and an Israeli ground incursion in her area.
She was only in her 7th month but, located more than five kilometers away from the nearest operational hospital, she had, she said, “no choice but to give birth at home.”
She turned to an elderly relative who had worked as a traditional midwife 40 years ago.
“She asked my husband to heat water in a container, and bring a knife and a clothes peg, so they could be sterilized with hot water before use.”
It was Hadeel’s first baby. It “wasn’t easy,” she said, and fear “I would lose my life or my baby due to this dangerous birth” haunted her. But baby Hiba was ultimately delivered healthily.
Complications
Nafisa Awad has no hesitation in conceding that the old methods can be more dangerous and of little use in cases of complicated deliveries or when there is need of caesarean sections.
A traditional midwife for 40 years, Awad, 71, has, she said, delivered “more than 500” babies in southern Gaza – she is from Bani Suhaila, east of Khan Younis.
“During traditional births, the midwife uses available tools, the most important of which is scissors to cut the umbilical cord, and to make incisions.”
But even the traditional method is now being undermined by Israel’s genocide. It’s hard to sterilize absent clean water. It is hard to avoid infections without soap, a scarce resource in Gaza. And there is not enough water to have pregnant women sit in warm baths to speed delivery.
Cinnamon and dates, both elements of the traditional method, are also all but impossible to get hold of.
In northern Gaza, midwives have been more active than in the south, especially since the Israeli military reinvaded and imposed a full curfew in the area at the beginning of October.
Nafouz Obeid, 43, had to give birth at home in Tal al-Zaatar on 17 October.
“I couldn’t go to the hospital because of the ground invasion in northern Gaza, and the heavy bombing,” Nafouz told The Electronic Intifada.
She turned to a traditional midwife who last practiced nearly 30 years ago, and who used a multipurpose pair of scissors to cut the umbilical cord. With no electricity, moreover, baby Mustafa was born in the light of a cellphone.
Despite the circumstances, both Mustafa and Nafouz came through without complications. Now, however, life under genocide has really taken hold.
“What my child, my family, and I need now is food,” Nafouz told The Electronic Intifada in an internet call. “A mother needs to eat properly in order to breastfeed, and there is no baby formula.”
Taghreed Ali is a journalist based in Gaza.
