(Jerusalem, January 28, 2025) – The Israeli government’s blockade of Gaza and attacks on healthcare facilities have created serious and sometimes life-threatening danger for women and girls during and after pregnancy and delivery since hostilities began in October 2023, Human Rights Watch said in a report released today.
The 50-page report, “Five Babies in One Incubator’: Violations of Pregnant Women’s Rights Amid Israel’s Assault on Gaza,” finds that Israeli forces’ unlawful blockade of the Gaza Strip, its severe restrictions on humanitarian aid, and attacks on medical facilities and healthcare personnel have directly harmed women and girls during pregnancy, childbirth, and the postpartum period. The Israeli government, as the occupying power in Gaza, has violated the right to the highest attainable standard of health and other rights of pregnant women and girls, including the right to dignified, respectful health care throughout pregnancy, childbirth, and postpartum, as well as the right to newborn care.
“Since the start of the hostilities in Gaza, women and girls are going through pregnancy lacking basic health care, sanitation, water, and food,” said Belkis Wille, associate crisis, conflict and arms director at Human Rights Watch. “They and their newborns are at constant risk of preventable death.”
The report is based on interviews with 17 people between June and December 2024, including 8 Palestinian women who were pregnant while living in Gaza during the hostilities, medical workers from Gaza, and international medical staff working with international humanitarian organizations and agencies’ operating teams in Gaza.
As of January 2025, emergency obstetric and newborn care is only available at 7 out of 18 partially functioning hospitals across Gaza, 4 out of 11 field hospitals, and one community health center, compared to the 20 hospitals and other smaller healthcare facilities that functioned before October 7, 2023.
In mid-January, Israeli authorities and Hamas agreed to a multi-phase ceasefire that includes the entry into Gaza of humanitarian aid, the return of Israeli hostages held in Gaza, and the release of Palestinian prisoners.
The quality of health care the few remaining medical facilities and service providers in Gaza can offer is extremely diminished. Women have been rushed out of sometimes packed hospitals within a few hours of childbirth to make room for other patients, many of them war casualties. All medical facilities in Gaza have operated in unsanitary and overcrowded conditions and have serious shortages of essential healthcare goods, including medicine and vaccines.
Two bills passed by the Israeli Knesset in October, which take effect in January 2025, threaten to further exacerbate the harm to maternal and newborn health. These new laws bar the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) from operating in Israel and occupied East Jerusalem and bar the government from contact with UNRWA, which would make it impossible for UNRWA to deliver aid into the occupied West Bank or Gaza or get permits or visas for its staff. Israel has ordered UNRWA to vacate all premises in occupied East Jerusalem and cease its operations there by January 30, 2025. UNRWA provides water, food, shelter, and other vital services to hundreds of thousands of Palestinians in Gaza, including pregnant women, nursing mothers, and newborn children.
Israeli forces’ military offensive has led to the forced displacement of over 90 percent of the population of Gaza – 1.9 million Palestinians – often multiple times. It has for the most part been impossible to inform women where they can safely access health services and difficult for women to reach the few available services safely in a timely fashion. Women, girls, and newborns have had almost no access to follow-up and postnatal health care.
Little information is available on the survival rate of newborns or the number of women experiencing severe morbidities or dying during pregnancy while giving birth, or postpartum. However, in July, maternity health experts reported that the rate of miscarriage in Gaza had increased by up to 300 percent since October 7, 2023. UNICEF reported that since December 26, 2024, eight infants and newborns have died from hypothermia due to a lack of basic shelter combined with winter temperatures.
A doctor at a maternity hospital in Rafah said they had so few incubators and so many preterm babies that “we have to put four or five babies in one incubator. … Most of them don’t survive.”
Israel’s unlawful blockade of Gaza and the use of starvation as a method of warfare has caused acute food insecurity for most people in Gaza. Pregnant women and girls face enormous obstacles to maintaining good nutrition and a healthy diet critical for their health and fetal development.
The government has also delibrately deprived Palestinians of access to water, which is a crime against humanity and an act of genocide. Many pregnant women have reported dehydration or being unable to wash themselves.
Many health conditions may be caused or significantly worsened by such deprivation, including anemia, eclampsia, hemorrhage, and sepsis, all of which can be fatal without proper medical treatment.
Pregnant women in Gaza have almost no opportunity to evacuate, though, under international human rights law, all civilians have the right to leave their country, including for medical reasons, as well as the right to return.
As the occupying power in Gaza, the Israeli government is also obligated under international humanitarian law to ensure that the civilian population gets food, water, and medical supplies to the fullest extent of the means available to the occupying government. Under the law, Israeli authorities are obligated to allow the free passage of all consignments of medical and hospital stores and of essential foodstuffs, clothing, and medical supplies intended for “children under fifteen, expectant mothers and maternity cases”.
The Israeli government’s allies, including the United States, should take all possible measures to end these and other grave Israeli violations. Governments should discontinue military assistance; review and possibly suspend bilateral agreements, such as the EU-Israel Association Agreement, as proposed by the governments of Spain and Ireland, and the US-Israel Free Trade Agreement; and support the International Criminal Court and other accountability efforts.
They should continue to support the efforts of UNRWA in Gaza, including all needed resources for sexual and reproductive health services. They should press Israel to ensure sexual and reproductive health and mental health specialists can enter Gaza without restrictions.
“Israeli authorities’ blatant and repeated violations of international humanitarian law and human rights law in Gaza have had a particular and acute impact on pregnant women and girls and newborns,” Wille said. “The ceasefire alone won’t end these horrific conditions. Governments should press Israel to urgently ensure that the needs of pregnant women and girls, newborns, and others requiring health care are met.”
