Even as the bombs fall on east Aleppo, babies are being born into the besieged city. For their mothers, experiencing pregnancy and childbirth in such desperate conditions is extremely challenging, both physically and psychologically.
The difficulties begin in early pregnancy. The siege has led to severe food shortages, and many pregnant women are undernourished, which can lead to severe anaemia and other health problems.
“Because of the food shortages and lack of good nutrition, a lot of pregnant women suffer from severe anaemia and low blood sugar, which can make them vomit or lose consciousness,” says Umm Wassim, a midwife who has been delivering babies in east Aleppo for 20 years. “Often the anaemia is so severe that they need a blood transfusion.”
Because of their mothers’ poor diets, many babies are born underweight. The stress of living under siege and bombardment has also led to an increase in babies being born prematurely. “When conditions are really bad, a lot of women are scared and suffer psychological stress,” says Umm Wassim. “[As a result] the number of premature babies has definitely increased.”
Even before the current bombardment, women struggled to reach east Aleppo’s one dedicated maternity hospital and the two other hospitals that offered maternity services. This was because of transport difficulties due to fuel shortages, and the danger of moving around the city under shelling.
“More women have been giving birth in the street, or at home, especially if their labour happens at night,” says midwife Umm Wassim. “Often women don’t arrive at the hospital until after they have given birth.”
But this month hospitals have come under attack again from airstrikes – including the only children’s hospital in the besieged area, the largest general hospital and three surgical hospitals, all of which went out of service. With such limited access to medical care, even pregnant women with complications may have to give birth at home or in local health centres, which offer only minimal services.
“There are no doctors around here,” says a midwife working in the basement of a health centre. “The only thing we do is gynaecological examinations. We don’t have a paediatrician. We don’t have incubators. There’s no medical equipment.”
After giving birth, many undernourished mothers struggle to produce enough milk to breastfeed their babies. Formula milk is no longer available, so parents are forced to feed their babies on unsuitable foods such as ground-up rice or bulghur wheat.
Some mothers feel desolate at bringing a baby into such a world. “For me, in these conditions, I think it’s a huge mistake,” says one new mother. “After I gave birth, I felt so sad. Did I give birth to him to see a life like this?”
But others still regard the birth of a baby as something to celebrate. ”The situation in east Aleppo is a tragedy,” says Umm Wassim. “We’re not used to all this fighting and bombing – it’s getting worse day by day. But despite all this, it’s still a happy occasion when a baby is born – why wouldn’t it be?”