Syrian women who are due to give birth in the three months post-earthquakes are most likely to miss out on critical maternal care.
The devastating earthquakes, which hit Syria and Turkey in February, have worsened the existing crisis in the healthcare system battered by the ongoing conflict and targeted attacks on hospitals and healthcare professionals.
“Challenges related to displacement, destruction of roads, lack of fuel, and limited health services provision will likely impact 148,000 pregnant women, 37,000 of whom are due to give birth in the three months following the earthquakes. Of these, 5,550 women may experience complications requiring emergency obstetric care, including C-section,” a new study suggests.
This grim reality is depicted in the study She Pays the Highest Price: The Toll of Conflict on Sexual and Reproductive Health in Northwest Syria, which shows how the 12-year conflict has disproportionately affected women and girls in conflict zones.
Pregnant women in the region reported that fear or experience of bombings, kidnappings, and exploitation have undermined their ability to attend clinics, left them without care and forced them to rely on informal health services. Medics added that they only attended to pregnant women during labour instead of four or six times throughout their pregnancy.
“Who would dare visit the hospital when it’s being targeted? We would be crazy to stay in the hospital,” said the women in an interview.
Limited services
Even for the women who are willing to go to hospital, there still exists a stark gap in the availability of services provided. Of the 367 functioning medical facilities in northwest Syria, only seven per cent offer comprehensive maternity care. Outpatient reproductive healthcare services exist in fewer than 40 per cent of facilities.
The study also shows that many healthcare facilities have been built in, or relocated to, geographic areas far from the frontlines. Healthcare providers, gynaecologists and midwives have moved their operations away from the fighting, limiting access to skilled care. As a result, pregnant women have been forced to travel long distances to seek medical care, putting them at further risk.
Additionally, due to large populations and demand in safer areas, these facilities experience significant overcrowding. Consequently, efforts to provide free delivery and newborn care have been limited and resulted into subpar maternal and newborn care services.
Aside from the direct consequences, women are also facing indirect impacts such as mental health issues and the increase of negative social practices. Those who are most marginalised, including girls in camps, those with disabilities, those from limited income sources, and adolescent girls are getting married off at a young age.
The study calls for accountability in parallel with a serious commitment to addressing violations of international law by parties to the conflict. This is in addition to commitment from donors to not only expand overall humanitarian assistance, but also to increase funding for essential sexual and reproductive services.
