Born too soon: Premature babies fight for survival in Gaza

Noor Salem, 30, stands beside an incubator at a neonatal intensive care unit in central Gaza, where her baby, Yazan Al-Khalidi, lies attached to tubes and monitors.

She watches his tiny body behind a sheet of quartz glass, tracking his meagre breathing and the slightest movement he makes.

Yazan was born eight months into Noor’s pregnancy, his body appearing bluish in the first moments of life.

This required immediate transfer to the neonatal intensive care unit at Al-Aqsa Martyrs Hospital in Deir el-Balah, after it became apparent that Yazan was born with breathing issues.

Instead of being able to hold her baby in the first moments after his birth, Noor is now forced to sit by the incubator and wait for Yazan’s condition to improve.

Yazan is Noor’s second child, having lost her first baby shortly after birth during the famine in Gaza in 2025, brought about by Israel’s ongoing genocide in the enclave.

During her pregnancy with Yazan, she endured shortages of basic necessities and a constant fear of losing another child.

Yazan Al-Khalidi, born in the eighth month of pregnancy. After birth, he experienced breathing difficulties [Eman Abu Zayed/Al Jazeera]

“I was afraid throughout my pregnancy because I had already lost my baby before. I was afraid I would go through the same pain again,” she said.

“When he was born, and I saw that he was not moving or crying like other babies, I felt terrified. I did not know what would happen to him. All I wanted was for him to survive.”

Noor waits for daily updates from doctors, hoping Yazan will overcome his health difficulties and return to her arms.

Rising premature births in Gaza

There has been a sharp increase in premature births and underweight newborns, as well as stillbirths and birth defects, since the genocide in Gaza began on October 7, 2023.

UNICEF has repeatedly warned about a crisis in premature births in Gaza, with one in every five newborns requiring intensive neonatal or thermal care. Maternal malnutrition, prolonged psychological stress and declining prenatal care services have all had an impact on both mother and child.

Dr Afnan Abu Hasaballah, an obstetrician and gynecologist working with UNRWA and Al-Awda Health Hospital in Nuseirat refugee camp, has personally witnessed the impact of this on the health of pregnant women and newborns.

She says many pregnant women arrive at hospitals suffering from severe stress and exhaustion after repeated displacement, deprivation of essential goods and bombings.

“Constant fear, repeated displacement, lack of food and clean water, and limited access to prenatal care all increased the risk of premature birth,” she says.

The Israeli siege on Gaza is also leading to severe malnutrition, and one of the main issues affecting both expectant mothers and their fetuses, leading to more premature births and low birthweights for newborns and requiring intensive care.

Inadequate nutrition also increases the risk of anemia, exhaustion for expectant mothers, pregnancy complications and restricted fetal growth.

“Many pregnant women during the war were unable to access sufficient or balanced food, and this directly affected the health of mothers and newborns,” Dr Abu Hasaballah says.

Pressure on Gaza health services

Al-Aqsa Martyrs Hospital is the only hospital with a neonatal unit in the whole of central Gaza, serving thousands of expectant mothers and causing immense pressure on overstretched health workers.

“We were working under enormous pressure, with shortages of incubators, ventilators, medications and basic supplies, in addition to repeated power and fuel shortages, which posed a direct threat to babies inside the incubators,” Dr Abu Hasaballah says.

Premature babies require continuous monitoring, oxygen, respiratory support, proper nutrition and treatment, something that health workers with their limited resources and time are not always able to provide.

“When these resources become unavailable, the risk of serious complications increases, including breathing difficulties, low body temperature, infections and low blood sugar,” Dr Abu Hasaballah says.

“Unfortunately, we may lose babies who could have survived if they had received basic care.”

The separation of mothers from their babies shortly after their birth is one of the hardest experiences for mothers to endure. This abrupt separation causes immense anxiety for both mothers and babies, with the most common question doctors at neonatal units are asked is whether their children will survive. Doctors and nurses do what they can to reassure the mothers and save the children.

“Instead of holding their baby and celebrating, mothers see them transferred directly to the incubator or intensive care unit. Their fear is doubled because the war has affected everything, from medical equipment and supplies to electricity shortages and overcrowding in hospitals,” says Dr Abu Hasaballah.

“We continued working day and night without sleep, and we did everything we could to save every child, but in many cases, the babies’ needs were greater than the resources available.”

Akram Abu Jiab, head of Qutoof Al-Khair Foundation, which supports pregnant women and newborns by providing vitamins and nutritional supplements for mothers, as well as medicines and medical supplies for children [Eman Abu Zayed/Al Jazeera]

New challenges for mothers

Once the parents and babies are discharged, a new struggle for families begins amid a landscape where a mother’s health has been impacted by deprivations and stresses of the war. Essential baby care items, such as sterilisation kits and baby formula, are absent or unaffordable.

“Many families have lost everything because of displacement, leaving mothers without baby clothes, diapers, blankets, formula or clean water,” Dr Abu Hasaballah says.

In Nuseirat refugee camp, central Gaza, Qutoof Al-Khair Foundation supports pregnant women and newborns by providing vitamins, nutritional supplements, medicines and essential medical supplies.

Akram Abu Jiab, head of the foundation, says his staff is dealing with growing demand for their services among pregnant women and new mothers who are unable to access enough food and healthcare to sustain their babies’ health.

“Premature babies require special care and continuous medical follow-up even after being discharged from incubators,” he says.

“However, many families are facing significant challenges in securing the basic medical and nutritional needs of their children.”

Despite the foundation’s efforts to reach as many mothers and children as possible, their efforts can only go so far.

“The scale of needs far exceeds the available resources. The gap between needs and support continues to grow every day,” he says.

“Behind every baby born in Gaza is a mother trying to protect her child under exceptional circumstances. Supporting mothers and children at this stage is not a luxury; it is a necessity to protect the lives of the next generation.”