Caesarean Sections Reach 25% of Births in Gaza

Al-Dahdouh stated that difficulty in travel caused by the war leads some pregnant women to arrive late to hospitals, reducing natural births and increasing emergency surgeries.

Al-Dahdouh also noted a growing trend of pregnancy as compensation for loss among women who have lost children or family members during the war in Gaza. He cited cases of women in their late 30s or over 40 deciding to become pregnant despite risks because they lost children during the war.

Dr Ruba al-Madhoun, an obstetrician-gynaecologist working at the International Medical Corps field hospital in Gaza, stated that many pregnant women arrive at the hospital in critical condition with injuries due to bombardments. These women suffer placental abruptions due to such injuries, requiring immediate surgery.

Al-Madhoun added that shortages in medical equipment and supplies, including continuous fetal monitoring devices and labour-inducing medications, increase reliance on caesarean sections.

Heavy pressure on hospital wards and shortages of staff make caesarean deliveries the fastest and safest option in some cases, al-Madhoun stated. She described severe overcrowding in wards where multiple patients share a single room. Al-Madhoun also noted a growing number of surgical wound infections in Gaza amid shortages of appropriate antibiotics and lack of laboratory capacity to identify bacteria.

Sanaa al-Shukri, 35, returned to the hospital 10 days after giving birth due to a recurrent infection in her caesarean wound. Doctors reopened the wound without anaesthesia and cleaned out accumulated pus, an experience al-Shukri described from her hospital bed. “I felt like my soul was leaving my body,” she told Al Jazeera.

Al-Shukri lives in a tent in Gaza City's Tuffah neighbourhood, where she faces major difficulties in her postpartum recovery. Doctors attributed her infection to the lack of a proper healing environment. Al-Shukri's husband, Mohammed, 50, lost his wife and seven children in a bombing on their home in Jabalia at the beginning of the war.

The couple named their newborn Ahmed after Mohammed's eldest son. Al-Shukri described the harsh conditions in her tent, including a terrible and unclean bathroom that is a pit in the sand full of flies and insects, and the absence of a wall to lean on or a bed, forcing her to sleep on the ground.

… It’s a pit in the sand, full of flies and insects, far away,” al-Shukri told Al Jazeera. She added that despite trying to clean the wound and change the dressing, it became infected, exacerbated by recent heat in the tents and unclean water.

The tents have become very hot lately, and doctors say the water is not clean,” al-Shukri said. Al-Shukri recounted hearing rats on the tarps all night, staying awake out of fear for the baby, and stated, “I started saying it is wrong to give birth in these tents.

… Heat, mosquitoes, flies, rats, dogs, … everything is here. … I will never give birth in a tent again. Displacement, malnutrition, deficiencies in protein and iron, overcrowded tents, and contaminated water affect wound healing and increase infection risks in Gaza, Al Jazeera reported.

These conditions amplify the dangers accompanying caesarean sections, particularly post-procedure infections, within a wider health system collapse.