In a half-destroyed apartment in Gaza City, 24-year-old Duha Abu Yousef sits on a mattress on the floor, holding her newborn baby with difficulty after an emergency cesarean section performed upon her arrival at the hospital the night before.
Abu Yousef, in her ninth month, had hoped for a natural birth. However, due to severe anemia, doctors decided to perform a C-section to protect her baby.
Throughout her pregnancy, she endured physical and psychological pain from Israel's genocidal war on Gaza. The most severe was famine and prolonged shortage of food and nutritional supplements, which severely weakened her body.
"Throughout my entire pregnancy, I didn’t taste meat, chicken or eggs, only in the last three months when things improved slightly," Abu Yousef told Al Jazeera. "Even nutritional supplements were unavailable. I was constantly unable to move, suffering from headaches and continuous nausea due to lack of food."
Famine and food shortages caused her to suffer from anemia throughout her pregnancy. "Any pregnant woman generally suffers from low blood levels, but food helps improve her condition. However, in Gaza, there is famine, iron deficiency and everything else," she said.
Compounding this was the psychological impact of her brother and his wife being killed by an Israeli tank shell in the early months of her pregnancy. "I was crying all the time, completely lost and deeply sad."
April is Caesarean Awareness Month, designated to raise awareness about the procedure. In Gaza, the dangers of C-sections are amplified by a collapsed health system. Dr. Fathi al-Dahdouh, head of obstetrics at Al Helou International Hospital, said C-sections have increased by about 2% since before the war, now making up a quarter of all births.
Travel difficulties due to the war mean some pregnant women arrive late to the hospital, reducing natural birth possibilities and increasing emergency surgeries. He also noted a growing trend of pregnancy as "compensation for loss," especially among women who lost children or family members.
Dr. Ruba al-Madhoun, an obstetrician-gynecologist at the International Medical Corps field hospital, said many pregnant women arrive in critical condition with injuries from bombardments, suffering placental abruptions requiring immediate surgery.
She added that shortages of medical equipment and supplies, including fetal monitoring devices and labor-inducing medications, have increased reliance on C-sections. Heavy pressure on wards and staff shortages also make C-sections the fastest, safest option.
Post-surgery dangers are severe, especially infection risk. Displacement, malnutrition, and deficiencies in protein and iron affect wound healing, while overcrowded tents and contaminated water increase infection risks.
Sanaa al-Shukri, 35, returned to the hospital 10 days after giving birth due to a recurrent infection in her C-section wound. She described intense pain when doctors reopened the wound without anesthesia to clean out pus: "I felt like my soul was leaving my body."
She lives in a tent in Gaza City's Tuffah neighborhood, facing major difficulties in postpartum recovery. "The bathroom is terrible and unclean, a pit in the sand full of flies and insects, far away. There is no wall in the tent to lean on, no bed, I sleep on the ground," she said.
Her husband Mohammed, 50, lost his entire family – his wife and seven children – in a bombing on their home in Jabalia at the start of the war. He has tried to rebuild his life with Sanaa. The couple named their newborn Ahmed after Mohammed's eldest son.
Despite her happiness at the birth, recovery inside a tent has become a daily struggle against harsh conditions. "I started saying it is wrong to give birth in these tents. Heat, mosquitoes, flies, rats, dogs, everything is here," she said.
Source: www.aljazeera.com