'Is it safe to have a child?': How Israel's war is reshaping fertility, pregnancy and parenthood in Gaza

Before Israel's war, for many women in Gaza, the decision to become pregnant began with a simple desire: another child, another room, another name to add to the family. Today, the question has become far more painful: is this the right time to bring a child into the world? 

Through my work and conversations with women from Gaza, I began to notice that the ongoing genocide has affected more than women’s ability to become pregnant or access infertility treatment. It has reached a stage that comes even before pregnancy itself: the decision to have a child. 

Some women are postponing pregnancy because they do not know where they will be living a month from now. Others fear pregnancy because of shortages of food and medication, or because they no longer trust that they will find a functioning hospital when labour begins.

Couples who married during the war have decided to delay starting a family after diapers, infant formula, medicine, and even basic food became difficult to secure. Others became pregnant during the war, only to have their experiences of pregnancy and childbirth leave them traumatised and unwilling to consider another pregnancy. 

In this sense, war does not affect only the children who are born during it. It reshapes the decisions of women and men who are still asking themselves, "Should we have children? When? And how many children can we bring into this world?"

Postponing the idea of family amid war 

Amal, 26, has been married for two years and has not yet had a child. Before October 2023, she was preparing for her first pregnancy.

She and her husband, Mahmoud, had begun undergoing the necessary medical tests, and she saw pregnancy as the natural next step in their married life. 

Then the war overturned those plans. 

Amal now lives in a displacement tent in the al-Mawasi area of southern Gaza. She says she no longer thinks about pregnancy in the same way she did before the war. 

"Mahmoud and I were preparing for our first baby. We had started the tests before October, but when we were displaced to a tent in Khan Younis, everything disappeared. How am I supposed to get pregnant when I can’t even find an aspirin or clean food? Pregnancy during war isn’t just a risk; it’s like putting your life in danger."

She pauses before continuing. 

"Every day I see women in the tents bleeding and unable to find a hospital. I told my husband to forget about having children altogether until the war ends — if I’m even alive by then." 

For Amal, postponing pregnancy is no longer a decision about comfort or financial planning. It has become an attempt to protect herself and a child who has not yet been born. 

She once dreamed of having four children. Today, she says that if the situation stabilises, she may have only one. 

This change in her idea of family size may seem deeply personal, but it raises a larger question: what happens when war becomes part of the calculations behind fertility decisions that were once based mainly on desire, financial circumstances, and social expectations? 

Amal is not the only woman who has spoken to me about delaying pregnancy. 

Ibrahim, 28, and Reem, 22, married in the middle of the war, after their second displacement. Before getting married, they had planned to start a family immediately. 

But their marriage itself took place under circumstances that bore little resemblance to a normal beginning to married life. 

They now live in a remaining room of a damaged house in Deir al-Balah. 

"Our wedding was held under a tarpaulin, with a displacement meal of canned beans. I can’t carry the guilt of bringing a child into a tent, where they might have to drink salty water," Ibrahim tells The New Arab.

"The price of a pack of diapers alone now requires months of budgeting. It’s absolutely not the time to have children. We’re barely surviving one day at a time."

Reem says, "My heart breaks every time I see displaced children. I wanted to become a mother as soon as I got married, but fear is stronger than emotion. Postponing pregnancy hurts us, but right now it is the only form of mercy available to us."

For the couple, the desire to have children has not disappeared. What has changed is the timing. 

When access to a hospital becomes part of the decision to become pregnant 

Under normal circumstances, pregnancy requires regular antenatal care, medical tests, medication, skilled birth care, and rapid access to a hospital if complications arise. 

In Gaza, however, access to these services can no longer be taken for granted. 

The destruction of health facilities and shortages of medicines and equipment have made reproductive care increasingly difficult, while international organisations have been working in 2026 to restore some essential services. 

In July 2026, UNFPA reported that 94 percent of hospitals in Gaza were either destroyed or only partially functioning, while fewer than half of health facilities were able to operate at any level. 

During the first half of 2025, around 17,000 births were recorded in the Gaza Strip, compared with approximately 29,000 during the same period in 2022 — a decline of more than 41 percent.

During the same period, health authorities recorded more than 2,600 miscarriages and 220 maternal deaths before childbirth, according to data cited by the United Nations Population Fund (UNFPA). 

UNFPA also reported that around 33 percent of babies born during the first six months of 2025 — approximately 5,560 infants — were premature, had low birth weight, or required admission to neonatal intensive care units. 

The decline in the number of births alone cannot be interpreted as evidence that women’s desire to have children has declined. It may also be linked to delayed marriage, poor nutrition, deteriorating general health and fertility, and reduced access to reproductive healthcare. 

But the figures reveal something more immediate: a woman deciding to become pregnant today is doing so in an environment radically different from the one that existed before the war. 

One of the women I spoke with, a 31-year-old, was 33 weeks pregnant when her story took its most devastating turn. 

She was living in a displacement site in northern Gaza when the nearby area came under attack, and she went into premature labour. 

She was taken to a temporary medical point, but the care she and her baby needed was unavailable. 

"I gave birth to the sound of bombardment, without even a single drop of anaesthesia. I was screaming from the pain and the fear at the same time."

Her baby was born prematurely and needed oxygen and neonatal care, but the available resources were insufficient. 

"I gave birth to my baby, and he was struggling in front of me, needing oxygen, and no one could do anything. He died in my arms a few hours later because the hospital went out of service."

She describes what the experience left behind: "Loss during war is not like any other loss. I feel as if the grief has suffocated me. I am not ready to go through that terror again or become pregnant with another child who could be lost in the same way."

Before that experience, she had not been afraid of pregnancy. Now, pregnancy itself has become a source of terror. 

'Women have started asking about contraception'

To understand this shift more closely, I also spoke with Dr Hiyam Jaber, an obstetrician and gynaecologist who has worked at Al-Aqsa Martyrs Hospital and in field displacement clinics. 

Dr Hiyam says that what she witnessed during the war was not simply an increase in pregnancy and childbirth complications, but a change in the questions women were asking. 

"We began receiving daily inquiries about safe, long-acting contraceptive methods, such as intrauterine devices and injections, particularly because birth-control pills are not consistently available," Dr Hiyam tells ​​​​​​The New Arab.

She describes women’s fears as being directly connected to their everyday experiences. 

"The greatest fears are giving birth without anaesthesia, giving birth in unsterile conditions, being unable to provide infant formula if the mother is suffering from malnutrition, and the fear of postpartum haemorrhage in a situation where blood supplies are limited," she adds. 

She says the cases she sees include an increase in preterm births and miscarriages, as well as emergency cesarean deliveries associated with deterioration in maternal health and delays in reaching hospitals. 

These observations do not exist in isolation. UNFPA has warned that one in three pregnancies in Gaza is now considered high-risk, while the food crisis and collapse of the health system have increased risks for mothers and newborns. 

In its report for the first quarter of 2026, UNFPA said it continued supporting sexual and reproductive health services in Gaza, including six mobile maternity units providing emergency obstetric and newborn care, as well as medicines, contraceptives, and medical equipment. 

But the very need for these mobile units reflects the scale of the crisis: safe childbirth is no longer a guaranteed service available everywhere. It has become a humanitarian issue, and health organisations are trying to rebuild amid the destruction. 

From four children to one 

According to Dr Hiyam, the shift she has observed is not limited to the question, "When should I become pregnant?" It also extends to another question: "How many children do I want?"

In her experience, many women are now inclined to postpone childbearing or have fewer children until the war ends and living conditions stabilise. 

This shift matters socially. Family size is not simply a number in demographic statistics. It reflects how people imagine their future. 

When a family is confident that there will be a home, a school, a hospital, food, and job opportunities, having another child can feel like a natural part of the future. 

But when the future itself is uncertain, the decision about how many children to have changes. 

Amal, who once dreamed of four children, now thinks about having only one. 

Ibrahim and Reem, who had planned to have children immediately after marriage, have decided to wait. 

And the woman who lost her baby says she cannot even contemplate another pregnancy. 

Three different decisions, shaped by the same fear. 

What will happen to the image of the Palestinian family? 

It is too early to say whether the war has created a permanent demographic shift in Palestinian family size. 

The data currently available describe an ongoing crisis and are not sufficient to answer the long-term question of fertility intentions after the war. 

But what can be said is that the war has intervened in nearly every factor shaping reproductive decisions: marriage, housing, food, healthcare, fertility, contraception, antenatal care, and the ability to protect a child after birth. 

In 2026, UNFPA estimated that around 55,000 pregnant women in Gaza were facing severe conditions, including displacement, hunger, and limited access to healthcare, while 120,600 pregnant women across the occupied Palestinian territory required pregnancy-related health services. 

These figures mean that the question of the future of the Palestinian family cannot be separated from the future of Gaza’s healthcare system and living conditions. 

When I asked Amal what she feared most, she did not talk about pain. She talked about giving birth to a child in a place where she could not protect them. 

When Ibrahim spoke about postponing parenthood, he did not say that he did not want to become a father. 

He said he did not want to feel guilty about bringing a child into these circumstances. 

And Reem summed up the entire struggle in one sentence: “Postponing pregnancy hurts us, but right now it is the only form of mercy available to us.” 

Perhaps this is the larger story. 

War does not only determine who will be born and who will survive. It can reach the moment before conception — the conversation between a couple in the darkness, the woman calculating the risks of childbirth before buying a pregnancy test, and the mother who has lost a child and decides that her heart cannot endure the experience again. 

In Gaza, the decision to have a child now carries questions that were not part of parents’ calculations before the war: 

Where will we live? 

What will our child eat? 

Will there be a hospital when I need one? 

Will I be able to secure treatment for my child? 

And will I be able to protect them? 

War does not only affect the children who are born. 

It also enters the lives of those who are still considering whether to have a child. 

"What hurts me most is that I have started hearing women ask a question I never heard before the war: ‘Is it safe to have a child?’ As a doctor, I used to help women welcome their babies. Today, I sometimes find myself trying to tell them that they have the right to be afraid," Dr Hiyam Jaber says. 

Perhaps the cruellest legacy of the war is not only the children who have lost their lives, but the mothers who have lost the ability to imagine a safe future for children who have not yet been born. 

In Gaza, where a child was once a symbol of life continuing, the decision to bring one into the world has, for many women, become suspended on a single question: 

Will this fear end before my child comes into the world? 

Dr Haya Hijazi is a gynaecologist and obstetrician from Gaza