Women & Girls’ Reproductive Healthcare

Dec 15

Through the Lens of Gaza in 2023

Trigger Warning: discussions of sexual assault and related topics

Written By Julianne Bullock

One commonality that women and girls all across the globe share is the need for reliable and high-quality reproductive healthcare. Key concerns that reproductive healthcare addresses are maternal health, menstrual health, and the treatment of sexually transmitted infections (STIs), among other important services. Being able to access these services is crucial for the physical, mental, emotional, and spiritual well-being of women and girls everywhere. Moreover, it is essential in order for them to pursue their aspirations and to thrive.

Due to Israel's continuing bombardment of the Gaza Strip as part of recent violence in the area, there has been an ongoing humanitarian crisis, confirmed by the UN and other international organizations. This has severely impacted women’s reproductive rights and access to healthcare in Gaza. The mass displacement of the Palestinian people, the destruction of hospitals, and the critical lack of resources and services have resulted in a dire state of affairs for women and girls in Gaza. Humanitarian aid is crucial in order to save lives. The assault on Palestinian women and girls’ reproductive rights must come to an end.

Maternal Health

A top priority for reproductive health advocates around the world is maternal care. This care extends from pregnancy to childbirth and the postpartum (after birth) period. According to the World Health Organization (WHO), “Although important progress has been made in the last two decades, about 287 000 women died during and following pregnancy and childbirth in 2020.” Moreover, every two minutes a woman dies as a result of pregnancy or childbirth.

In Gaza, there are an estimated 50 000 pregnant women, with over 180 giving birth on a daily basis. WHO reports “[...] some women are having to give birth in shelters, in their homes, in the streets amid rubble, or in overwhelmed healthcare facilities, where sanitation is worsening, and the risk of infection and medical complications is on the rise.” Maternal mortality is expected to surge as the devastation continues and women and teenage girls do not receive vital maternal care. It is abundantly clear that more work needs to be done on a global and local scale to ensure the safety and well-being of mothers. This is especially apparent as most maternal deaths can be prevented by consistent access to trained and experienced physicians and maternal health experts.

WHO highlights postpartum hemorrhage (PPH) as the leading cause of maternal mortality in the world. PPH is uncontrolled and excessive bleeding after childbirth. Besides death, it can also cause trauma to the body and mind. With proper treatment, PPH can be avoided. Unfortunately, for women and teenage girls in Gaza, PPH is a much greater risk due to lack of medical resources and improper birthing conditions. In line with this, women in Gaza are being forced to give birth without painkillers. One such mother is a young woman named Kefaia Abu Asser who delivered her daughter without pain relief. She told BBC news, “There was a shortage of painkillers, so they only administered it if the pain became really unbearable and only to those most in need.” Kefaia’s story further shows us that the reproductive rights of women in Gaza are being violated in the most tragic ways.

Menstrual Health

Knowledge about menstruation and access to sanitary products such as pads and tampons are crucial aspects of women and girls’ reproductive healthcare. However, many lack education about this natural bodily phenomenon, do not have access to menstrual hygiene products, experience stigma surrounding menstruation, lack access to proper care when menstruation is irregular, and experience period poverty (inability to afford menstrual products). In areas embroiled in conflict or disaster, lack of proper menstrual healthcare is only exacerbated.

In Gaza, it is becoming increasingly difficult for people to acquire any medical or sanitary supplies, including menstrual hygiene products. Hind Khoudary, a Palestinian woman, tells the news outlet Middle East Eye about her struggles with her period since becoming displaced, due to the relentless attacks on Gaza. She says, “My last period was my worst, because I am homeless, I am living out of my backpack, there’s no access to toilets or anything.” Hind mentions something important here; the sanitation infrastructure in Gaza has collapsed. This is yet another factor that prevents women and girls in Gaza from being able to properly manage their periods. Moreover, it increases risk of disease and sickness.

In these times of immense stress, Palestinian women and girls are experiencing irregular menstrual cycles, which only compounds onto the anxiety that they already feel in trying to manage their periods. One woman named Salma Khaled told AlJazeera news “I got my period twice this month so far – which is very irregular for me – and suffered heavy bleeding.” Salma’s irregular cycle only makes the lack of sanitary products in Gaza more of a problem. In an attempt to solve this issue, Salma and many other women and girls have been taking period-delaying pills. This medication, called norethisterone, is effective but has various side-effects including nausea, dizziness, and mood swings. While women and girls are able to avoid the hardships of having their periods in this time of crisis, they may be trading in these struggles for different negative health outcomes. However, for many, period-delaying pills are currently the best and most accessible option.

STI Treatment

Sexually transmitted infections (STIs) are responsible for a substantial amount of deaths worldwide. The global contraction rate is also sky-high with more than 1 million STIs being acquired on a daily basis. The most common STIs include chlamydia, gonorrhea, HPV, herpes, and HIV, among other diseases. STIs disproportionately affect women and girls, partially due to reproductive anatomy. Moreover, “STIs can also be transmitted from mother-to-child during pregnancy, childbirth and breastfeeding.” There are many negative outcomes for women that can arise from contracting an STI; cervical cancer, infertility, pelvic inflammatory disease, etc.

According to the Human Rights Watch, “[...] women and girls typically are at increased risk of sexual violence in times of armed conflict.” This pertains to the women and girls in Gaza who are victims to sexual abuse and in need of immediate medical attention. Beyond trauma to the body and mind, there is risk of STI transmission as a result of sexual assault. This needs to be addressed through prompt treatment.

The high prevalence of STIs among women and girls can also be attributed to barriers to access. As previously mentioned, contraception is not readily available in many parts of the world. This is especially apparent in areas experiencing a crisis, such as Gaza. The lack of access is problematic for many reasons including the fact that condom use is essential in preventing the transmission of STIs. Additionally, there needs to be improved access to immunizations for HPV and hepatitis B, as well as sexual health clinics where people can be screened for STIs, diagnosed, and promptly treated.

Female reproductive healthcare saves lives, and each life that it saves belongs to a remarkable woman or girl. Being able to easily access high-quality reproductive healthcare continues to be an important aspect of fulfilling women's and girls’ human rights. This rings especially true for Palestinian women and girls. That is why actions must be taken to end the bombardment of Gaza, address the humanitarian crisis as well as its effects on women and girls and their reproductive health, and prioritize the collective well-being of the Palestinian people.

Sources

Access to sexual and reproductive health services

https://plan-international.org/srhr/access-to-srhr-services/

Israel’s Unlawful Blockade of Gaza Sparks Women’s Rights Crisis

https://www.hrw.org/news/2023/10/24/israels-unlawful-blockade-gaza-sparks-womens-rights-crisis

Maternal health

https://www.who.int/health-topics/maternal-health#tab=tab_1

WHO issues global plan to tackle leading cause of death in childbirth

https://www.who.int/news/item/11-10-2023-who-issues-global-plan-to-tackle-leading-cause-of-death-in-childbirth

A woman dies every two minutes due to pregnancy or childbirth: UN agencies https://www.who.int/news/item/23-02-2023-a-woman-dies-every-two-minutes-due-to-pregnancy-or-childbirth--un-agencies

Menstrual Health

https://www.unfpa.org/menstrual-health