No Safe Delivery: Inside the UN's Record of Gaza's Maternal Health Crisis

By 2025, doctors working in Gaza's maternity wards were observing something with no precedent in their careers. Healthy, full-term newborns had become rare. The explanation, physicians say, lies in what 18 months of severe food shortages has done to pregnant women.

That detail appears in the June 2026 report of the Independent International Commission of Inquiry on the Occupied Palestinian Territory, filed to the UN Human Rights Council. The Commission was established by the Council and operates independently of any government. Its mandate covers violations and crimes in the Occupied Palestinian Territory since 7 October 2023, and its latest report, running to nearly 90 pages, focuses specifically on Palestinian children.

One section has received considerably less attention than the casualty figures. It examines what the Commission calls "reproductive violence" and its direct impact on birth outcomes in Gaza. The findings draw on hospital data, interviews with medical staff, and assessments from UN agencies including United Nations International Children's Emergency Fund (UNICEF), United Nations Population Fund (UNFPA), and World Health Organization (WHO).

The Numbers, in Context

In the first half of 2025, Gaza's Ministry of Health recorded 17,000 live births whereas in 2022, the figure stood at 29,000, this marks an overall decline of 41%.

That fall does not sit in isolation as it comes alongside a sharp rise in pregnancy complications. By October 2024, women in Gaza were three times more likely to die in childbirth and three times more likely to miscarry than before the conflict began. By March 2026, one in three pregnancies was classified as high-risk. In the first half of 2025 alone, 2,600 pregnancies ended in miscarriage and 220 resulted in intrauterine foetal deaths.

Before October 2023, miscarriage rates in Gaza stood at between 7% and 9% of all pregnancies. By July 2024, the Commission found, they had risen by up to 300%.

For the babies who are born, the situation is similarly serious. Before the conflict, approximately 9.5% of newborns in Gaza were premature and 9.1% were underweight. By March 2026, United Nations Office for the Coordination of Humanitarian Affairs (OCHA) reported that 70% of all newborns in Gaza were classified as either premature or underweight.

Why This Is Happening

The Commission identifies two interlocking causes: the collapse of neonatal healthcare infrastructure and acute, widespread maternal malnutrition.

Before October 2023, Gaza operated eight neonatal intensive care units with 178 incubators. By November 2024, three units in northern Gaza had been destroyed and the total number of functioning incubators across the territory had fallen to 54. By September 2025, Médecins Sans Frontières (MSF) reported only 36 incubators remaining in northern Gaza. Medical staff described three or four infants sharing a single incubator at a time. By August 2025, newborn bed capacity across Gaza had halved, denying an estimated 2,500 infants access to critical neonatal care.

Without incubators and temperature control, premature infants face acute risk. Between December 2024 and February 2025, at least 15 newborns died from hypothermia. UNICEF described these deaths as preventable. In the same two-month period, Nasser Medical Complex admitted 274 neonates, of whom 35 died, whilst Al-Aqsa Hospital admitted 203, of whom 17 died.

Maternal malnutrition compounds every one of these risks. Folic acid, multivitamins, and nutritional supplements were reported as consistently unavailable across Gaza's supply chains. Folic acid deficiency during pregnancy is a well-established cause of neural tube defects in newborns, including spina bifida. Medical practitioners interviewed by the Commission reported a documented rise in neural tube defects, congenital heart defects, and gastrointestinal malformations in babies born across Gaza since October 2023. These conditions are treatable under ordinary circumstances but require specialist surgery and sustained monitoring. In Gaza, the report found, those services were largely unavailable.

Breastfeeding, which is critical for newborn immunity and nutrition, has also been severely disrupted. Maternal malnutrition, lack of clean water, and repeated displacement have together compromised lactation for large numbers of mothers. The Commission documented cases of mothers feeding infants a mixture of star anise and water as a substitute for formula, a practice carrying documented risks of electrolyte imbalance in newborns.

The Legal Conclusion

The Commission places these reproductive and neonatal findings within its broader legal analysis.

It finds that Israel violated the right to life, survival and development of the child under the Convention on the Rights of the Child, the right to the highest attainable standard of health, and the prohibition of cruel, inhuman, or degrading treatment.

On the question of genocide, the Commission finds the documented harm to birth rates and neonatal health falls under the category of "imposing measures intended to prevent births within the group," one of five underlying acts recognised under the Rome Statute. The Commission states it reaches this conclusion on reasonable grounds, noting that repeated warnings from UN agencies about the foreseeable consequences of the siege went unaddressed by Israeli authorities. The Israeli government did not respond to any of the 13 requests for information submitted by the Commission during its investigation.

What the UN Is Recommending

The Commission's recommendations are directed at multiple parties.

To the Government of Israel, it calls for an immediate end to attacks on healthcare facilities, the urgent reconstruction of damaged neonatal and maternity units, guaranteed safe medical evacuation for critically ill patients, and unrestricted entry of humanitarian organisations carrying medical supplies, food, and clean water.

To Member States, the Commission urges concerted pressure to end the siege of Gaza "immediately, completely and permanently," and calls for a halt to arms transfers where there are reasonable grounds to suspect their use in operations involving violations of international humanitarian law.

To the UN Secretary-General, it calls for formal monitoring of what it terms the denial of humanitarian assistance to Gaza within the Children and Armed Conflict framework, noting that the current situation meets all five primary categories defined under that agenda.