Born besieged: Syrian mothers struggle to care for newborns
More premature babies are being born in besieged East Aleppo as mothers bear the psychological toll of war.
With hospitals all destroyed or out of service, and just a handful of doctors to some 275,000 people in the rebel-held side of the Syrian city, expectant mothers are giving birth in the street or at home, says medical charity Doctors Without Borders (MSF).
Lack of humanitarian aid reaching the districts means mothers are too malnourished to feed their babies.
Formula milk is no longer available so parents resort to feeding newborns ground-up rice or bulgur wheat.
"When conditions are really bad, a lot of women are scared and suffer psychological stress," said Umm Wassim, a midwife who has been delivering babies in East Aleppo for 20 years.
"[As a result] the number of premature babies has definitely increased."
"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," she added.
"Often, the anaemia is so severe that they need a blood transfusion."
Even before the current bombardment, without enough fuel to drive and the danger of falling bombs, women struggled to reach East Aleppo's one dedicated maternity hospital and the two other hospitals that offered maternity services.
|After I gave birth, I felt so sad. Did I give birth to him to see a life like this?
"More women have been giving birth in the street, or at home, especially if their labour happens at night," said Umm Wassim. "Often women don't arrive at hospital until after they have given birth."
Last month, the last hospital in East Aleppo was bombed 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, MSF said.
"There are no doctors around here," said 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."
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," said 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?"