By Amelia Hankins & Ghadir Hamadi
Edited by Sintia Issa
Baby Fatima was two days old when the world she had just been introduced to was turned upside down. As the claw of Israeli aggression once again dug into Lebanon, her family wrapped her in a blanket and drove to Beirut from their home in Blida, a border village 1.5 kilometers from the Blue Line. There was nowhere to go, no one who could or would take them in, so they ended up in a shelter at the Lebanese University, in Corniche el-Mazraa, along with 400 other people.
The shelter is in rough shape, as are many. Overcrowded, with only four toilets and nothing resembling privacy. A week later, Fatima was joined by her cousin, baby Ali. His mother had arrived at the shelter nine months pregnant, about to deliver. The next week, a third woman at the shelter also gave birth, by cesarean, leaving her with a wound she must tend to alongside caring for her baby. These women and their newborns now sleep on mattresses on the ground in rooms shared with several other families: one window, no showers, scarce water, and a bathroom that is impossible to keep clean.
As part of its campaign to empty southern Lebanon of its residents, either by displacement or death, Israel ordered the depopulation of around 850 square kilometers between the border and the Litani River on March 4, the third day of its latest war against Lebanon. The next day, Israel extended the displacement order to the 700,000 people living across Dahieh, Beirut’s southern suburbs. Then, on March 12, it placed all land south of the Zahrani River, which spills into the Mediterranean just south of Saida, under threat of bombardment, roughly 50 kilometers from the Blue Line, effectively rendering the entire region a potential kill zone.
Barely 16 months after Israel’s last major bombing campaign, more than 1 million people in Lebanon are once again fleeing to find a semblance of safety. At least 12,000 of all forcibly displaced individuals are pregnant women, and more than 1,500 of those women are currently living in one of the 662 government-run shelters, according to a report from the United Nations Population Fund (UNFPA).
Survival under these conditions is relentlessly stressful — and for an unborn child, that stress can be deadly. As in the 2024 war, midwives we spoke to say women are having devastating miscarriages or premature deliveries as they flee their homes.
“On the very first night, seven women gave birth,” says midwife Joumana Taher. “Not in hospitals, but on the road, after being stuck for long hours while fleeing.”
With a fractured state apparatus struggling to meet the basic needs of the displaced, pregnant women risk falling through the cracks. But Lebanon’s midwives are answering the call.
When the war broke out, some 250 midwives joined a country-wide network offering free care to displaced pregnant women, the president of the Lebanese Order of Midwives, Rima Cheaito, tells The Public Source.
Building on the system they developed in 2024, and with the support of UNFPA, these midwives visit shelters, staff government-run primary health care clinics, and, when feasible, make house calls. Many of these midwives are themselves displaced.
Some remained in the South, providing care on the front lines until evacuating in the war’s third week as Israel started targeting bridges and cutting off roads. Taher is one of them. She remains in her hometown of Saida, a southern coastal city where several residential buildings have been hit.
She regularly visits pregnant women in five shelters across two municipalities. When the bombardment keeps her from seeing the women under her care, she checks in with them over the phone. “My message to all women is: we are always by your side,” Taher tells The Public Source. “You are not alone.”
Midwives are especially valuable in times of crisis because they are deeply embedded in their communities, says Maguy Ghanem, a sexual and reproductive health specialist with UNFPA. Guiding one of the most cherished moments in family life — the birth of a child — they inhabit a more intimate sphere than most doctors or hospital nurses.
This rootedness gives them access to the most vulnerable and hard-to-reach members of their communities, Ghanem says. Midwives maintain strong connections with municipalities and local leaders, allowing them to quickly obtain information about, and for, those who need help.
“We also play a key role in the early detection of complications,” Taher adds. “Since we’re there, providing care throughout the pregnancy and afterwards too.”
The midwifery network is highly adaptive to the changing realities on the ground. Material and financial support is primarily provided by UNFPA, while the Order coordinates the midwives’ work. The logistics of daily operations — clinic services, mobile units, house visits — are carried out by various organizations, including the Amel Association, Makhzoumi Foundation, and the Imam Sadr Foundation, with guidance from the Ministry of Public Health.
Midwife Darine Ayoub wakes up every morning and goes to her designated healthcare facility, where she and her team of 12 healthcare providers and data collectors climb into a van and head out to conduct check-ups at five shelters in Beirut. Ayoub is currently caring for five pregnant women.
Ayoub herself was displaced from her home in southern Beirut. Unlike the women she cares for, however, she has a home to go to. The midwife has family in the mountains above Beirut, where she and her children are now staying.
“There were more host communities in 2024,” Cheaito says. “This year, fewer people are willing to take others, and many have stayed in their homes because they couldn’t find anywhere else to go.” At the same time, many landlords north of the warzones have raised rents, sometimes three or four-fold, exploiting fear and desperation.
Many feel they have nowhere to go. Midwives and program coordinators say this reality is the central threat to the health of displaced pregnant women.
The sound of Israeli fighter jets roaring overhead, nearby airstrikes, and the fear of expanding displacement orders form a constant backdrop to daily life. Basic everyday tasks, from changing clothes, and doing laundry to washing or using the bathroom — taken for granted by anyone not crammed in a hastily converted school with hundreds of other people — are a major source of stress.
There is little privacy. People have to wait in line to use a toilet shared by dozens, and when it is finally their turn, it is missing water or supplies.
Ahlam Sayegh is the midwife for the shelter where newborns Ali and Fatima and their families took refuge, as well as another shelter in Beirut, where she is caring for two pregnant women, one close to giving birth.
For Sayegh, along with Cheaito, Ayoub, and several other midwives, the biggest problem at the shelter is the lack of privacy and the difficulty in keeping anything clean, as these make-shift shelters are overcrowded far beyond capacity. Sayegh spends much of her time with expectant and new mothers, helping them adjust their hygiene and self-care habits to the dire conditions they now find themselves in.
“I show them how to clean themselves with little water, how to clean the toilets before using them,” Sayegh explains. “I teach them how to separate, as much as they can, the space they use. So, sleeping in a different place from where they eat, eating in a different place from where they brush their hair, or from where children play.”
Cheaito, Ayoub, and Sayegh report a worrisome trend: to avoid the communal toilets, women are drinking less water. This leaves them dehydrated and prone to getting urinary tract infections.
When there is no water to wash clothes or clean underwear to change into, the risk of fungal infections increases. And infections are especially risky during pregnancy.
Stress alone harms the unborn. In wartime, it compounds: the stress of survival, of staying clean, of enduring constant uncertainty. Pregnant women find themselves caught in a catch-22: they know that stress can harm the baby, and that knowledge only deepens their anxiety.
Sheltering in a crowded school in the Aley district, Lina Ayash clutches a small bag containing her prenatal vitamins — the only item she took when fleeing bombardment.
“The first thing I thought about was my pregnancy,” she says. “I took my vitamins because I was afraid I wouldn’t find them again.”
Ayash is three months pregnant and fled her home in Nabatieh on March 3. Her husband, a volunteer with the Lebanese Red Cross, stayed behind to care for the wounded on the frontlines, so she has had to navigate the chaos alone.
“He is always so careful,” she recalls in a soft voice. “He would remind me about every appointment, make sure I took my vitamins, and tell me not to carry anything heavy. Now, none of that routine exists, and I’m scared something might happen to the baby.”
Despite the midwives’ visits and care, Ayash still worries. Without prenatal exams or ultrasound scans, she cannot know for certain that her baby is safe. “They try to help when they come,” she says. “But it’s not the same as seeing my doctor. I just hope everything will be okay until I can go back home.”
Rama Husseini, who is six months pregnant with her first child, fled her home in Shmastar in the Baalbek region, on March 2, when the U.S.-Israeli war on Iran expanded into Lebanon.
Before her displacement, Husseini received prenatal care at the hospital in Riyaq. The sudden flight from home disrupted that routine, severing her from the medical team she relied on.
“I was being checked regularly from the beginning of my pregnancy,” she says. “Now everything is uncertain. I worry about my baby all the time.”
Husseini’s situation illustrates another challenge for midwives. Within their own communities, they are well connected. But amid such upheaval, they have to pick up where other doctors or midwives left off.
“We don’t know these women personally,” says veteran midwife Yolla Atallah. “We don’t know their medical history, but we have to do whatever is needed.”
So much of the midwives’ work, both during and between crises, involves sharing knowledge and providing comfort, says Atallah, who has been a midwife since 1986. She has been “catching babies” — as it’s often referred to in the midwifery world, as a way of centering the effort of the mother during labor — since the bomb shelters of the civil war.
Teaching women how to care for themselves gives them autonomy and agency, improving their well-being, as demonstrated by the skills Sayegh shares with the women under her care. It also helps them better understand what is happening to their bodies.
“Most women are afraid for their babies,” says midwife Gabriella Younes. “They want ultrasounds so they can check that their babies are okay.” At a clinic in her Jdeideh community, she provided care for 60 displaced women in just the first week of the war.
“Fear affects everything,” Younes adds. “They are afraid of everything. Even once their baby is born, they worry about being unable to produce milk for them.”
Ayash says the sound of every strike makes her heart race and she cannot shake the fear of miscarriage. Miscarriages linked to stress, Younes explains, are associated with elevated cortisol levels that affect hormones and blood circulation, eventually limiting the amount of oxygen and nutrition that flows from the mother to the fetus.
Sleep deprivation also increases cortisol levels, and rest is difficult when one of the world’s most powerful and belligerent armies is dropping bombs nearby. Even on quieter nights, sleep offers little restoration. On a thin mattress on the floor, in a room with 40 other people, or curled in the backseat of a car, pregnant women wake up more exhausted than when they went to sleep.
Ayash’s mind rarely quiets long enough for rest. “Sometimes I worry someone might roll over in their sleep and hurt me… and I’d lose my baby,” she says.
Since fleeing Shmastar, Husseini and her husband have been sleeping in their Toyota Avanza parked along Ramlet al-Baida. Days after she spoke to us, Israeli strikes targeted the beachfront in a double-tap attack, killing eight people.
“I thought the hardest part of this pregnancy would be the delivery,” Husseini says. “I never imagined I would be carrying my baby while living in a car.”
At night, the couple tries to make the cramped backseat as comfortable as possible, but sleep remains difficult.
“There is no proper place to rest,” she says. “Sometimes I wake up because the baby is moving and I can’t even stretch my legs.”
“All I want right now is a safe place to sleep and proper care for my baby,” she continues. “I’m about to become a mother, and I don’t even know where my child will be born.”
—The Order of Midwives has created a hotline for pregnant women and new mothers forced to leave their homes because of the war. They can access free midwifery services, either in person or over the phone, by calling 70 118 723.
Amelia Hankins is a Beirut-based writer and editor. Her recent work has appeared in L’Orient Today and the Markaz Review. She is currently working on a project tracing her family’s experience during the Great Famine of Mount Lebanon.
Ghadir Hamadi is a journalist and founder of Sawab, a youth-led fact-checking initiative combating fake news and hate speech in Lebanon. She currently works at L’Orient Today in Beirut. Find her on X.
Sintia Issa is editor at large at The Public Source.
This article has been republished with permission from The Public Source. You can read the original article here.