2023–2024 Gaza Strip Preterm Births

The war that began in October 2023 severely disrupted maternity and neonatal services across Gaza. The World Health Organization estimated that thousands of women gave birth in unsanitary conditions, often without clean water or medical assistance, and some women who reached a functioning hospital underwent caesarean sections without anesthesia.[1] A January 5, 2024 live report quoted UN humanitarian chief Martin Griffiths saying that roughly 180 Palestinian women were giving birth each day while Gaza's few partially functioning hospitals were overwhelmed and critically short of supplies.[2]

In January 2024, UNICEF reported that nearly 20,000 babies had been born in Gaza since the war began — a pace described as approximately one birth every ten minutes — though the report did not specify how many of those births were premature.[3]

Neither the Palestinian Authority nor Hamas published birth statistics for Gaza covering 2023 or 2024, with the absence attributed to the war and the difficulty of collecting complete data.[4]

The U.S. Department of State's 2023 Country Report on Human Rights Practices relayed an Oxfam report from November 2023, which attributed to Gaza-based partner Juzoor for Health and Social Development an estimated 25–30 percent increase in premature births.[1] Juzoor linked the increase to heightened stress on pregnant women, including fleeing bombardment and living in overcrowded, unsanitary shelters. The report did not specify the comparison period, underlying birth counts, or the methodology used to calculate the increase.[1]

The same report noted that cases of placental abruption — a potentially life-threatening complication for both mother and baby — had more than doubled in northern Gaza in particular, according to Juzoor. As with the preterm-birth figure, no baseline count or defined comparison period was provided.[1]

Al-Shifa Hospital in northern Gaza became the focus of the most extensively documented episode involving premature infants during the conflict. Hospital officials were reported as caring for 36 premature babies at Al-Shifa on November 14, 2023.[5]

Claims about infant deaths at Al-Shifa during the power crisis differ. Ynet reported that Gaza health authorities claimed five premature babies and seven other patients died following power outages at the hospital. The same report said Al-Shifa had earlier claimed that three of its 39 premature infants died after the generator supplying the neonatal unit was damaged in shelling. The hospital said the remaining infants were taken out of incubators, manually ventilated, and moved to a unit where oxygen remained available. Ynet did not reconcile the two reported death counts.[6]

Initial reports said 31 premature babies were moved from Al-Shifa to another Gaza clinic, while 29 were reported to have arrived in Egypt on November 20; the reason for the difference was not explained.[5] Mako reported that Israeli forces enabled the transfer of infants from Al-Shifa to Egyptian hospitals after coordination by the Gaza Coordination and Liaison Administration, following requests from Egyptian authorities and the hospital director. That report did not specify the number transferred or state that every infant was premature.[7]

Israel made multiple attempts to deliver neonatal equipment to Gaza hospitals during the crisis. The IDF stated that it delivered medical equipment, incubators, and baby food to Al-Shifa Hospital on November 15, 2023, with IDF medical teams and Arabic-speaking soldiers present to help ensure the equipment reached those who needed it.[8] Egypt was also reported to be examining with Israel and the United States the possibility of evacuating premature infants by ambulance convoy prior to the eventual evacuation.[9]

However, Muneir al-Barsh, director general of Gaza's Hamas-controlled Ministry of Health, stated on November 17 that the hospital had not received Israeli incubators.[10] The available sources do not resolve this conflict between the IDF's account and al-Barsh's denial. In early March 2024, Israel sent 50 incubators to hospitals in Gaza; the receiving hospitals were not identified, and no data was provided on how many premature infants used them.[11]

A separate Israeli field-hospital response was documented by COGAT in April 2024: the Jordanian Field Hospital in Khan Yunis operated a premature-newborn ward with 40 incubators, reported at 7.5 percent occupancy as of April 24, 2024.[12]

A separate and contested episode involved Al-Nasr Children's Hospital, evacuated on November 10, 2023. A March 2024 Washington Institute review described conflicting accounts about premature infants in the neonatal unit at the time of evacuation. An unnamed nurse claimed he carried one baby to an ambulance; a nurse identified as Fadi Abu Riyala stated that no patients could be taken; the hospital director's account held that five infants were left behind. The review noted unresolved differences in the number of infants left, uncertainty about whether they were alive when staff departed, whether oxygen was functioning, and when or how deaths occurred.[13]

The U.S. State Department report separately relayed a UN Office for the Coordination of Humanitarian Affairs account that at least four babies were found dead weeks after the evacuation of Al-Nasr, discovered in their hospital beds.[1] The circumstances of those deaths — and the relationship between those four infants and the various nurse accounts — remained unresolved in the reviewed sources.

The reviewed sources chiefly document specific hospital episodes and reported childbirth conditions rather than population-level preterm-birth statistics for the 2023–2024 period.[5][1] No Gaza-wide preterm-birth total, rate, gestational-age distribution, or birth-weight data was located in the reviewed material. The reported 25–30 percent increase in premature births lacks a defined baseline, measurement methodology, or comparison period, and the proposed link to stress and displacement represents Juzoor's reported attribution rather than an independently established causal finding.[1]

The available 2024 material is limited to the March 2024 incubator shipment and the April 2024 field-hospital capacity figures; neither establishes a preterm-birth rate or trend for that year.[11][12]

Several key figures and claims in this record are contested or unverified. The discrepancy between the 36 premature infants reported in Al-Shifa on November 14, the 31 initially reported as moved from the hospital, and the 29 reported as arriving in Egypt was not explained.[5] Competing Al-Shifa accounts citing three and five premature-infant deaths were not reconciled.[6] The conflict between the IDF's stated delivery of incubators and the Hamas health ministry official's denial of their receipt likewise remained unresolved.[10]

The neonatal-unit accounts from Al-Nasr present further contradictions about the number of infants left behind, whether any survived, and the circumstances of their deaths.[13] Claims about deaths, infrastructure damage, and hospital conditions during the war originated in significant part from parties to the conflict or from accounts that the reviewed sources could not independently reconcile.[13][6]