Introduction
Two years of war have devastated every aspect of life in Gaza. The health system has been systematically targeted, with consistent violations of international humanitarian law. Most recently, during the ground invasion of Gaza City which started in September 2025, a health centre operated by Médecins du Monde was destroyed without warning by Israeli military authorities. The attacks and displacement of Médecins du Monde’s premises and clinics represent just a few examples of the repeated attacks on healthcare in the Occupied Palestinian Territory. As a result, sexual and reproductive health and rights (SRHR) services, already fragile before the war, are now facing extreme staff shortages, as well as lack of supplies and safe facilities. Women, adolescents and newborns are among the most affected, experiencing limited access to antenatal care, emer gency obstetric services, family planning, menstrual hygiene supplies and protection from gender-based violence. This report highlights the impact that two years of war and the blockade of humanitarian assistance has had on sexual and reproductive health in Gaza. It demonstrates – once again – the disproportionate impact of armed conflict on women and girls. The report identifies some of the challenges faced by communities and health providers in sexual and reproductive healthcare and the urgent actions needed to safeguard women’s dignity, rights and lives.
Methodology
The report is based on data collected from Médecins du Monde’s primary healthcare centres in Gaza City and the Middle and southern areas of the Gaza Strip between May 2024 and August 2025. While the total number of SRHR consultations over the period represents 5.4% of all primary healthcare consultations (22,747, out of 424,958 primary healthcare consultations), among women of reproductive age they constitute 15%–30% of these consultations. In addition, between March and July 2025, Médecins du Monde conducted specific research on maternal health to provide more detailed information. The research was based on data from around 100 women who had been pregnant during this period, randomly selected according to the research protocol from across the territory of Gaza.
Médecins du Monde’s operations in the Occupied Palestinian Territory
Médecins du Monde has been operating across the entire Occupied Palestinian Territory for more than 20 years, with a team of 120 staff in Gaza and 78 in the West Bank. In Gaza, our teams provide primary healthcare through several primary healthcare centres. Services include general medical consultations, mental health and psychosocial support, sexual and reproductive healthcare, vaccination and nutritional support. In the West Bank, Médecins du Monde operates from Ramallah in the south to Jenin in the north. The team supports the rehabilitation of local primary healthcare centres, provides medicines and medical equipment and deploys a mobile health unit to meet increased needs, particularly in mental health. The team also works to strengthen emergency preparedness among health actors. In February 2024, Médecins du Monde launched the direct delivery of primary healthcare services through mobile medical teams in Rafah. When Rafah was evacuated in May 2024, Médecins du Monde installed static primary healthcare centres in the Middle area, and northern Gaza. These centres offer a comprehensive package of curative consultations, sexual and reproductive health and rights services, maternal and child healthcare, including vaccination, minor trauma care, non-communicable disease care and mental health and psychosocial support.
MAIN FINDINGS
Overview of sexual and reproductive health consultations at Médecins du Monde primary healthcare centres in Gaza
During the reporting period, monthly proportions of sexual and reproductive health consultations fluctuated between 15% and 30% of the primary healthcare consultations sought by women and girls over the age of 15. While the proportion of sexual and reproductive health consultations grew steadily during the ceasefire period between January and March 2025, it suddenly decreased in March 2025 when humanitarian aid was completely blocked, highlighting the direct impact of the extreme humanitarian situation on access to sexual and reproductive health and rights services. Similar patterns observed across the three areas of operation expose a structural vulnerability of sexual and reproductive health services during crises: while needs remain constant, service delivery is highly sensitive to security constraints, displacement and humanitarian impediments.
Between May 2024 and August 2025, Médecins du Monde’s medical teams observed that women were primarily seeking curative sexual and reproductive consultations (to treat pathologies), rather than preventive care (which would be more usual in primary healthcare services). Over the entire period, the number of consultations for genital infections was significantly high – and higher than the number of antenatal consultations.
2. Reduction in antenatal care and consequences for pregnancies
Médecins du Monde’s main finding of a reduction in preventive sexual and reproductive healthcare between May 2024 and August 2025 is corroborated by the significant reduction in comprehensive pregnancy monitoring. In 2022, the average number of antenatal consultations was 6 to 7 consultations per woman in Gaza, whereas the WHO recommends 8 consultations. The comprehensiveness of the follow-up differed between UNRWA health facilities (61.5%) and Ministry of Health facilities (28.9%). In the focused study conducted by Médecins du Monde between March and July 2025, only 18% of the patients received comprehensive antenatal care. Incomplete antenatal care and lack of access to this care have devastating impacts on pregnancies and on the health of women and infants.
2.1. Sharp increase in pregnancy complications
As part of scientific research conducted on the health of pregnant women and their children, Médecins du Monde analysed data from around 100 women who had been pregnant between March and July 2025 and who were randomly selected from across the territory of Gaza in accordance with the research protocol. They were asked about their pregnancy, their access to healthcare during pregnancy, medical follow-up for their newborns and the conditions in which they were living.
Table 2: Proportion of pregnancy complications diagnosed in Médecins du Monde health centres between March and July 2025 March – July 2025 (%)
The total is greater than 100% because the same person may have multiple complications.
In 2022, the Gaza Strip had a maternal mortality rate of 17 per 100,000 live births, placing it among countries with low maternal mortality rates and comparable to North America (world average = 197 in 2023). While recent data are limited, the rate of pregnancy complications before the conflict can be estimated at around 10%, consistent with other stable contexts with similar maternal mortality ratios.
Our field observations indicate that approximately 85% of pregnancies now present at least one complication, which is extremely alarming. This represents an 8-fold increase in high-risk pregnancies, translating into a 5- to 6-fold higher risk of maternal death. These deaths, resulting from disrupted antenatal care, lack of medications, malnutrition and damaged health infrastructure, are directly connected to the extreme living conditions, the organised famine and the destruction of the health system in Gaza. They can be added to the deaths resulting from direct exposure to violence. Projections suggest that these maternal deaths could reach around 100 per 100,000 live births. This excludes maternal deaths caused directly by the conflict (bombardment, gunshots etc.), which would further increase the total risk. The situation underscores the urgent need to prevent both visible and invisible losses.
The combination of a high prevalence of anaemia (59%) and infections (51%) among pregnant women at Médecins du Monde health centres reveals a maternal and neonatal health situation that is critical. These complications expose women to severe immediate risks, including haemorrhage, sepsis, poor tolerance of blood loss during delivery, extreme fatigue and increased maternal mortality. For infants, these pregnancy complications can lead to intrauterine growth restriction, preterm birth and low birth weight, as well as long-term consequences for children as they grow up (poor growth, cognitive and motor deficits, long-term chronic conditions and increased risk of infertility).
The risks are not only potential ones. Among the 100 pregnant women who participated in the study, more than 20% of their newborn children were affected, with almost 10% of babies dying during their first days of life. These observations are only the impacts that are visible during the very first months of these children’s lives and do not include health conditions which may develop as they grow.
The fragility of health structures, coupled with the lack of diagnostic equipment and essential medicines, amplifies these risks, underscoring the urgent need to put an end to the attacks on the health system and lift the blockade to ensure maternal and neonatal services in Gaza are strengthened.
“Pregnant women are giving birth in overcrowded shelters, makeshift tents or on the road while fleeing airstrikes, often without medical assistance, pain relief or sanitation. In this context, reproductive justice is not only denied; it is deliberately and systematically violated.”
Dr Israa, Sexual and Reproductive Health (SRH) advisor at Médecins du Monde
“I received a 30-year-old woman suffering from foetal growth restriction due to acute malnutrition. She had very low blood pressure and had been scheduled for a C-section, but she had lost contact with her gynaecologist due to the recent evacuation from Gaza.”
Dr. Hiba, family doctor Médecins du Monde
Dramatic increase in miscarriages among displaced women and girls
The Ministry of Health and the Sexual and Reproductive Health technical group report an increase of 300% in miscarriages in Gaza since October 202316. Additionally, Médecins du Monde medical teams report an increase in need and demand for comprehensive abortion care. Displacement is a factor in both lack of contraception in cases of non-intended pregnancies and lack of access to healthcare and the devastating impact of the conflict in cases of miscarriage.
“Pregnancy doesn’t pause during war. Neither should our responsibility to protect those giving life.”
Dr. Israa, SRH advisor Médecins du Monde
3. High prevalence of menstrual disorders
Menstrual disorders are disturbances of the normal menstrual cycle, including irregular bleeding or unusually heavy or painful periods. In humanitarian settings, these disorders are often exacerbated or triggered by multiple factors such as chronic stress, psychological trauma, malnutrition, forced displacement and exposure to violence. During this period, Médecins du Monde’s teams have encountered an unusually high number of women facing disruptions in their menstrual cycle. These disorders are much more than a personal inconvenience — they are biological signals that the body’s reproductive system is under stress and cannot function normally anymore.
“For Palestinian women and girls, the ability to exercise even the most basic reproductive rights is now a daily battle for survival.”
Dr. Israa, SRH advisor Médecins du Monde
“The ongoing war is not only destroying infrastructure and lives. It is destroying the future, womb by womb.”
Dr Israa, SRH advisor, Médecins du Monde
CONCLUSION
Médecins du Monde’s analysis of sexual and reproductive healthcare based on data from its primary healthcare centres show that appalling living conditions due to continuous attacks and subsequent displacement are having tremendous negative impacts on basic access to sexual and reproductive healthcare for women and girls. The war is preventing women and girls from living in dignity and from accessing decent sanitary conditions and the healthcare they need as women, pregnant or not, including food and nutrients necessary to carry pregnancies and care for infants. Because of their special health needs, war disproportionally affects women and girls. The conduct of the war by the Israeli army since October 2023, and its specific impacts on women and girls, could be considered as “causing serious bodily or mental harm to members of the [Palestinian] group” and, to some extent, given the high rates of pregnancy complications and their consequences, “imposing measures intended to prevent births within the group” as per Article II of the 1948 Convention on the Prevention and Punishment of the Crime of Genocide. As observed during the ceasefire between January and March 2025, the cessation of attacks, especially against civilians and civilian infrastructure, including health facilities, as well as the influx of humanitarian aid, are the main factors which save women’s and girls’ lives and improve their health.
RECOMMENDATIONS
> Médecins du Monde continues to advocate for an immediate and permanent ceasefire and the protection of civilians.
> All attacks on medical infrastructures and personnel must stop immediately.
> All crossing points must be reopened to ensure large scale humanitarian aid is available in Gaza, including restoring access to safe drinking water in sufficient quantities, medical equipment and all basic drugs. Third States have a responsibility to use all measures in their power to prevent the destruction of the Palestinian people in Gaza.
> Sexual and reproductive health services must be prioritised as much as possible within the current circumstances by the humanitarian community.
SOURCE: Médecins du Monde, October 2025. https://doctorsoftheworld.ca/uploads/Report-SRHR-Gaza-ENG.pdf