Many women are also caring for extended family members who have lost a male relative. A woman caring for her deceased son’s baby reported: “We depend completely on aid and soup kitchens. To reach food, we walk long distances, often only to return with nothing. When food is available, the portions are too little to feed so many mouths, and the rice and lentil meals are unsuitable for infants.” Family separation and deaths of male relatives also leave young women to be responsible for caring for younger siblings. A young university student related: “Every morning my little brother asks me, ‘How will we eat today? What will we eat?’ I have no answer.” Pregnant and breastfeeding women Before the war, in 2022, Gaza’s maternal and newborn health system, while fragile, maintained critical functions: the maternal mortality ratio was 17.4 per 100,000 live births; the low birthweight rate stood at 8.0 percent; and, annually, approximately 10,000 neonates required Neonatal Intensive Care Unit (NICU) services.47 Since the war began, conditions have deteriorated dramatically. By mid-2025, hospitals faced collapse due to fuel shortages, leading to equipment shutdowns and the near impossibility of providing safe deliveries. According to the Gaza MoH, there were 17,000 live births recorded during the first half of 2025, a 41 percent decline compared to the same period in 2022.48 Gaza also witnessed alarming increases in maternal and neonatal complications between January and June 2025: 2,600 miscarriages, 220 pregnancy-related deaths, 1,460 preterm births, 1,600 underweight newborns, 2,500 NICU admissions, and at least 21 infants who died within 24 hours of birth.49 Key informants warned of rising maternal and newborn risks due to food insecurity: malnourished pregnant women face higher odds of complications, miscarriages, and stillbirths, and many are giving birth in dire conditions without medical care. An estimated 55,000 pregnant and breastfeeding women require treatment for acute malnutrition and 11,000 pregnant women in Gaza are at risk of imminent famine.5051 A survey conducted in April 2024 revealed that three-quarters of pregnant women in Gaza were anemic, and 99 per cent could not access essential nutritional supplements. Among breastfeeding mothers, 99 per cent reported challenges securing enough breastmilk, compromising infant survival, growth, and development.52 Infants born to starving mothers, some in overcrowded shelters or in the rubble of destroyed hospitals, are dangerously underweight and vulnerable.53 A frontline health worker described: “We are seeing women forced to give birth in tents, on school floors, even in the open air. There is no sterile equipment, no electricity for lights, and sometimes not even clean water. Mothers deliver on plastic sheets or pieces of cloth. I have witnessed women giving birth while children cry around them, and we can do almost nothing. The lack of incubators and medicines means that babies who are born too early or too small often die within hours. These are not conditions for childbirth - they are conditions for death.” A social worker in Khan Younis said: “I delivered my baby on the floor of a shelter with no midwife, no medicine, and no light. My daughter was born too weak to cry.” 16