If you want to see me at my most earnest and tender,
I highly recommend joining me for a run. I took up the sport 10 years ago this year and have experienced thrilling highs, humbling lows, seen the world (literally—I have run everywhere from Tokyo to Thessaloniki) and learned valuable life lessons thanks to the act of consistently lacing up and putting one foot in front of the other.
When it comes to women’s sports, we’re in a historic moment. And so, there was only one cover star choice
for our Women In Sports issue: A’ja Wilson, the supernova center for the Las Vegas Aces who is leading the WNBA to new heights. She’s a two-time champion, two-time MVP, and two-time Olympian, but it’s the changes she’s pushing for off the court—like speaking out against the gender pay gap—that strike me as most impressive. “When people ask me what I do and why, it’s like I’m
not just living for myself, but for generations before me,” she tells cover story writer and Marie Claire executive editor, Andrea Stanley.
While Wilson may be in her prime at 27, the roster of remarkable women we feature in “The Rise of the Middle-Age Athlete,” prove that middle-age may actually be the best years for competing. Their stories are inspiring examples of how life doesn’t have to stop as we get older.
Elsewhere in the issue you’ll learn about those who are making a difference from the sidelines—the female investors who are buying up pro sports teams (“These Women Own Sports") and the stylists turning the tunnel walk into a fashion show (“The Stylists Turning the Tunnel Walk Into a Fashion Show”).
Lastly, we’re launching a new column called
Exit Interview where we’ll have candid conversations with people who just left their job. To kick it off, I spoke with professional athlete Alexi Pappas who has found freedom in no longer “trying to define” where her career is headed. And in the story “From Syrian Refugee to Two-Time Olympian,” swimmer Yusra Mardini opens up about the power of sports, and how watching the human body defy what’s possible, shows us all that we’re capable of something truly great.
the militant group that controlled Gaza and which had launched a surprise attack on Israel last October, killing some 1,200 people. An Israeli rocket tore through the Abeds’ apartment building soon after. Abed, her husband, and three-year-old son took refuge with extended family in central Gaza, with 19 people sharing one apartment. She prayed the war would end before she gave birth.
For months, Abed, 29, could not find a doctor or midwife for her prenatal appointments because so many hospitals in Gaza were bombed out or closed. So she turned to her mother for advice; she fretted that she wasn’t getting the prenatal vitamins or nutrition she needed. The family lived on canned beans and the occasional vegetable. There was no fruit, meat, or fish. She fainted multiple times due to the poor diet and vomited from contaminated water.
Anytime Abed imagined her baby’s future, she panicked, worrying about what would happen if she couldn’t breastfeed and formula wasn’t available, or if she was killed and her baby orphaned, as by the spring 19,000 children would be. Her young son had lived through multiple conflicts with Israel, but “these were like escalations, they were not wars,” she said. “I just don’t want to see my baby suffering the way people are suffering here.” She dreamed of giving birth in peacetime, when she could provide her child with mangos, cucumbers, and bananas.
By summer, the death toll of the war was staggering; the medical journal The Lancet estimating that in July 2024 between seven and nine percent of the population of the Gaza Strip had been wiped out. Some half of all deaths were women and children.
“Maybe you hear that people of Gaza, they love death, or they know nothing except death. But actually, we people of Gaza, we love life.”
O
n the 10th day of the war, Safa Abed learned she was pregnant, and cried. When she told her husband, he said this was no time to have a child, but they would manage, somehow. They had fled their home in Gaza City when Israel declared war on Hamas,
(Photo credit: Getty Images)
Lesser known is the story of birth taking place amid so much death, with about 180 babies being born in Gaza every day. Mostly, it is a story of extreme hardship—a maternal health crisis where nearly every mother is malnourished like Abed, leading to preterm and low birthweight babies, miscarriages and stillbirths; women who cannot reach the few remaining hospitals to give birth due to the danger, so they deliver unsafely at home or in tents; gender-based violence against birthing women on the rise, spurred on by all the stress; serious infections in both mother and child; postpartum hemorrhaging of the mother, sometimes leading to death; and nearly every woman suffering from post traumatic stress—trauma they pass on to their babies.
Juliette Touma of the United Nations Relief and Works Agency (UNRWA), one of the main UN agencies providing emergency humanitarian aid to Gaza, said that she has worked in conflict zones for decades, and never seen a crisis of this magnitude. “I tell you, it’s probably one of the most difficult places on earth to be a woman,” she said, especially a woman who is pregnant. But it is also a story of heroism, of the doctors, midwives, and other healthcare staff who are delivering babies and caring for birthing women amid tanks and bombs and gunfire; who are continuing to work despite having lost homes and belongings and loved ones themselves. As Touma puts it to me: “How do you care for someone when you yourself need help?”
remaining OB-GYNs, midwives, and nurses worked long hours in barely-functioning labor and delivery units or makeshift tent clinics with few supplies in chaotic conditions, the sound of explosions and gunshots around them, and the fear they could be raided at any time.
Maternal healthcare workers knew the war would be disastrous for birthing women and their babies. Yet Mohammed Alreqeb, M.D., an OB-GYN who was living with his family in Khan Younis in the south of Gaza when the war began, said that what has happened since was “beyond my worst dream.”
When he was displaced to Rafah, also in the south, he set up an emergency maternity tent clinic there, where he said he “was forced to deliver many babies with no equipment and very simple and old techniques.” With no cord clamp for the umbilical cord, he used thread, and with no sterile knives, he used a kitchen knife or scissors. “I never expected to face such extreme conditions,” he said. But with around 155,000 pregnant and breastfeeding women in the Strip, any maternity care was desperately needed.
Providers said many women didn’t want to get pregnant during the war but birth control was difficult to find. Or, like Abed, they learned they were pregnant just as the war began. Alreqeb said some women were doing medical abortions by pill, but it was illegal in Palestine, so most opted not to. As a result, some 20,000 babies have been “born into hell,” as UNICEF said in January.
O
ver the next few months, as Abed’s baby grew, the maternal healthcare situation in the Strip grew dire. Of Gaza’s 36 hospitals, the majority were bombed, raided, or shut. Hundreds of healthcare workers were killed, while others fled the region. The
(Photo credit: Salma Helmi Awni Kaddoumi)
Malak Abu Sultan, a 22-year-old woman the United Nations Population Fund (UNFPA) interviewed, described the health issues that plagued her baby boy ever since she gave birth to him during the war: His eyes were swollen and red from lack of sleep and humidity, and he’d developed a dry cough and cold from the smoke of nearby fires. Sometimes, he turned blue from coughing due to phlegm. Sultan was too afraid to travel to the hospital for help, “so I’m basically his doctor,” she said.
Flies bit them all the time. At night, they were kept up by airstrikes. When they hit, Sultan’s baby often hugged himself. “A four month old [who] understands what airstrikes are?” she said, more of an outraged question than a statement.
Alreqeb tried to reach as many women like Sultan as he could with his maternity tent clinic. Since 2017, he’d worked as an OB-GYN at Nasser Medical Complex, one of the largest hospitals in Gaza, but it had been closed for months after the Israeli Defense Forces (IDF) struck it multiple times and then raided it in February 2024, claiming that the dead bodies of the hostages were there. The raid killed three of Alreqeb’s immediate colleagues and caused the hospital to run out of food, water, electricity, and oxygen for patients.
(Photo credit: Salma Helmi Awni Kaddoumi)
(Photo credit: Bisan Owda)
Alreqeb spoke to me over WhatsApp in June after a 24-hour shift at a hastily rebuilt and reopened Nasser Medical Complex. Israeli forces were still laying siege nearby, so he and just four other doctors delivered nearly 80 babies amid screams of fear and pain as the building shook from nearby bombs. The ward was so overcrowded with birthing women and the general wounded, he said, “that we don’t have any chance to raise our heads and see the patient. We just work, work, work.” Alreqeb took one break that shift to eat a small meal of bread and cheese before going home to his nearby tent. It was the latest place he was sheltering after being forced to flee seven times. Nine out of 10 Gazans are internally displaced.
Over the next few weeks, Alreqeb sent regular updates from Nasser Medical Complex: a video of the packed and chaotic waiting room, a photo of himself in worn scrubs, with a half-smile and eyes red with exhaustion, and a photo of a chubby boy he’d delivered healthy. This is what keeps him going, he said—the joy in women’s faces when they meet their babies for the first time. “That happiness is very unique,” he said. “And that gives me much happiness, actually.”’
A UNRWA midwife in central Gaza told a similar story of a pregnant woman who came into her clinic during the war and, upon hearing that her baby had a heartbeat, “instinctively hugged me in sheer happiness.” Like Alreqeb, she’d found that there was some joy that war could not steal.
(Photo credit: Bisan Owda)
before the war—baby clothing was wildly expensive. But Abed had a more pressing concern: where she’d give birth. Shuhada al-Aqsa Hospital, the main hospital in central Gaza, had become a “martyrs hospital” to receive the wounded and the dead. The other nearby option was a private hospital called Al-Awda, but it was beside a refugee camp that the IDF regularly targeted, so it was dangerous to deliver there.
Abed had developed a “phobia” of delivering a baby under the circumstances, meaning possibly in a tent or at home, with no doctor or midwife to help her. “I’m in the 39th week of my pregnancy. That is one week away,” she said in a WhatsApp call, her lilting voice faltering a little. “I am very afraid of a ground invasion… I am very panicked about delivering a baby at home… And I am scared that the malnutrition that is spreading in the Gaza Strip will affect me and my baby’s health.”
According to the humanitarian agency CARE International, women were three times more likely to die in childbirth or miscarry than before the war, so Abed knew she or her baby might not make it.
Meanwhile, in Vancouver, Canada, more than 6,000 miles away, a 37-year-old midwife named Heba Al-Nashef scrolled through the terrible images from Gaza on social media, and told herself she had to do something. Al-Nashef is of Arab heritage, and she had long wanted to assist on a medical mission. “So eventually it was just, let’s go, like I can do it, I don’t have an excuse not to,” she told me by video call, her tone matter-offact. “I can help my people during a genocide.”
B
y June 2024, when Safa Abed was nine months pregnant, her belly swollen and energy sapped, food had become even more difficult to obtain. There were no diapers and, though the family wasn’t poor—she and her husband were both graphic designers
To get to Gaza, Al-Nashef traveled from Canada to Jordan to the Karam Abu Salem border crossing between Israel and Gaza. She went as part of a United Nations delegation, with support from the medical supplies company Glia, taking leave from her various jobs, including her clinical practice and administrative position as the assistant head of midwifery at St. Paul’s Hospital in Vancouver.
Driving into Gaza in June, Al-Nashef said, the scene was “apocalyptic.” She passed entire towns of gray rubble with no one on the streets, “empty and all destroyed, like a game with zombies.” Finally, Al-Nashef arrived at Al-Awda Hospital in northern Gaza, where ambulances with the wounded regularly pulled up and where she’d be assisting as a midwife in labor and delivery.
When we spoke over WhatsApp during her first week in Gaza, the lights went out behind Al-Nashef in the dorm where she was staying before a generator kicked in. Her voice was hoarse, her dark hair pulled back in a ponytail. Like Alreqeb, she said the shortage of supplies was a major issue for their maternity staff. They didn’t have the right sutures for women sometimes, or enough CPAP machines for respiratory support, or safe umbilical cord clamps for the babies. Some midwives were using the lace of a mask, soaked in alcohol, to wrap around the umbilical cord to stop it from bleeding.
(Photo credit: Hussein Owda from UNRWA)
In describing the scene of the births in her first few days, Al-Nashef said: “It’s 35 degrees [Celsius], with a hot sewage smell, and no clean running water. When a woman pushes and you see the head, [only] then do you bring them downstairs.” In the delivery room, a woman often had to give birth with three other women beside her, their cries filling the room. Vaginitis, an infection that could lead to extended tearing, was rife. As a result, staff were regularly doing episiotomies on women—a painful, mostly outdated practice that involves making a cut in the area between the vaginal opening and anus. Al-Nashef said this was not evidence-based but it was her job to help, not lecture, the staff.
Once the baby was born, there were no sheets to absorb the amniotic fluid or dry the baby, she went on, so they used diapers instead. Since every birthing woman was also anemic from malnutrition, they were at a high risk of postpartum hemorrhaging, which could be fatal. Even if a woman didn’t hemorrhage, there was little time for the important, intimate practice of skin-to-skin contact between a new baby and their mother. “A woman welcoming a baby to this world is supposed to be a gentle experience,” Al-Nashef said. In Gaza, it is dangerous and chaotic.
Al-Nashef’s first day at Al-Awda Hospital had begun normally enough, with an orientation with the head of OB-GYN. Then, bombs went off outside and the building began shaking. It was early June, and the IDF was conducting a daytime raid on the Nuseirat refugee camp next door, during which it rescued four of the remaining 116 hostages Hamas had been holding—while also killing at least 274 Palestinians according to the Gaza Health Ministry. Soon, the wounded and the dead bodies started coming in on stretchers to the hospital.
“It was a horrific scene,” Al-Nashef said. “A massacre.” That first night, a pregnant woman came into the hospital around seven or eight centimeters dilated, “crying and crying” in a way that seemed beyond the usual cries of pain during labor, Al-Nashef said. It turned out that her husband and five children had all been killed in the raid. After the woman’s baby was delivered, she and the staff had to quickly move on to the next patient. “Dwelling on it doesn’t serve the people that I’m supposed to serve,” she said. Every one of Al-Nashef’s colleagues, she adds, was “overworked, overstretched but was not complaining. They just do the work and go back to their tent or dorm,” sleep, and wake up to face life—and death—again the next day.
“I said, ‘Forget about it, no one is coming close, just have the baby.’ I’m suturing her and hearing the firing, trying to calm her down, and you just have no idea what’s going on.”
and friends. Alreqeb’s wife had learned she was pregnant before the war started. All the displacement had been especially hard on her; fleeing first from their apartment in Khan Younis to a former school-turned-shelter, then another, and another. For a month, they lived inside Nasser Medical Complex where Alreqeb worked, before having to flee from there.
In January 2024, Alreqeb said, he, his wife, and their three-year-old daughter, Mariam, were on the move again, out of Khan Younis because Israel was escalating its ground invasion there. Their destination was Rafah, just six miles away but hours on foot with no available vehicle or fuel.
The day was bitterly cold and rainy, and Alreqeb remembers carrying their bags and Mariam in his arms, while making jokes to try to cheer up a 35-weeks-pregnant Issra. Thousands of other Gazans accompanied them on the grim march to Rafah. At one point, Alreqeb recalled, Israeli tanks were so close they could see them. “If they wanted, they could kill us. But Allah must have had us,” he said. Eventually, he convinced a man to put Issra on a donkey cart.
When they made it to a tent in Rafah, Issra suddenly began having contractions. Alreqeb was sure she was in preterm labor because of stress. The nearby Al-Helal Al-Emirati Maternity Hospital in Rafah was open and packed. The electricity was going on and off in the labor ward. Only a couple midwives were on duty for nearly 30 women in labor. Alreqeb worried about the unsanitary conditions for both Issra and the baby.
After five hours, when the baby crowned, Alreqeb realized he was going to have to deliver the baby himself, which worried him because “usually the person who is a doctor to their own family makes the wrong decision.” But he safely delivered their baby girl, who they named Salma, which means “safe and sound.”
Salma came out with a cleft lip, which Alreqeb attributed to his wife’s exposure to toxic gasses and chemicals during the war. Otherwise, she seemed healthy and they left the hospital to go home. Within two days, they were back. Salma was sleeping too much and refusing to feed. Alreqeb realized she had pneumonia, which could be fatal if she developed sepsis. He managed to secure an incubator for Salma but the hospital said it would need to add more babies soon, which could give Salma another infection. So he took her into his and Issra’s arms, gave her antibiotics, and prayed.
I
n Gaza, everyone has their own tragic story. “And maybe I will tell you some of my story,” Alreqeb told me, quietly. He explained that he and his wife and daughter had lost their home, their belongings, their savings, as well as dozens of relatives
(Photo credit: Heba Al-Nashef)
The lack of fuel to power ventilators has been a persistent maternity care problem in Gaza; among the most devastating stories came in December 2023, when the IDF laid siege to a hospital where Palestinian doctors made the heartbreaking decision to leave four premature babies behind on ventilators they needed to survive. When a journalist returned, the babies were found long dead.
By May, when Salma was still sickly, Alreqeb said he managed to secure safe passage for his wife and daughters to Egypt so she could get better medical care there. The agents at the border told him he could not also cross without paying $13,000—a sum he did not have. So Alreqeb said goodbye to his family and stayed behind.
In telling this story, the doctor sounded exhausted; the next time I spoke to him he sounded hopeless. It was July, and he was being told to evacuate for the eighth time. This time, Alreqeb had to travel from the east to the west of Khan Younis, where many other people were crowded in the streets to avoid the IDF’s latest attack. He called me after he got the order, and said he wasn’t going to move his tent despite the danger because there was nowhere for him to move it to. “I prefer to die than go in the streets,” he said.
Death had become so normalized—with so many women dying in labor, babies dying as they were born, and people dying everywhere. “I got used to death everyday,” he said. “He died, that person died, and I'm just waiting for my turn.”
O
n June 24, 2024, on the 262nd day of the war, Safa Abed finally gave birth. A few hours after her contractions started, she left home, but chose not to go to Al-Awda Hospital because of the danger. Instead, she went to a tent clinic newly set up in central
Gaza by the International Medical Corps. Pain relief was not available for her eight-hour delivery, so she had to work through excruciating contractions. Against all odds, her baby boy was born healthy. She named him Yamen, which meant “generosity and ease,” something she longed for.
Abed stayed at the hospital for just a few hours after the birth and then went home because there wasn’t space to keep women for long. There, she groaned in pain and bled for days. But she was able to breastfeed, and Yamen thrived. Food was scarce but enough. She imagined a better future, of taking him to schools and parks and restaurants. Of having ease again.
At Al-Awda Hospital, Al-Nashef was nearing the end of her six-week medical mission. When a bomb went off, she instinctively knew to jump away from the glass because the IDF usually struck a second time. One of her fellow midwives had nearly lost her arm to shrapnel. She'd spoken to young boys who acted like men, including one who held his brother in pieces. She'd watched as more women gave birth to preterm babies, like Alreqeb’s wife had, likely from the stress of war.
One day in July, Al-Nashef heard a drone outside the hospital that she thought was a “zenana,” which means “buzzing” in Arabic—an IDF drone that is loud on purpose to let people know they’re under surveillance. But it was a quadcopter, a far more terrifying drone with four rotors that can kill people at close range. Al-Nashef was helping a woman push out her baby when the quadcopter started shooting. The woman panicked. “I said, ‘Forget about it, no one is coming close, just have the baby,’” Al-Nashef said. “I’m suturing her and hearing the firing, trying to calm her down, and you just have no idea what’s going on.”
Where before her colleagues were overworked, now “they are holding on by a thread,” she said. “They went to work, helped people have their babies…but they’re so exhausted, they kind of dissociate.” When Al-Nashef finally left Gaza for home, she immediately began thinking about returning later this year. She struggled with guilt at having left her colleagues behind. “Something about Gaza takes a piece of your heart and leaves it there,” she said.
In Cairo, Alreqeb’s daughter, Salma, received a much-needed surgery. Between shifts at the hospital, Alreqeb speaks to his wife and daughters over WhatsApp as often as he can. All he wants, all any ordinary person in Gaza wants—the mothers, the humanitarian agencies, the doctors and midwives—is a ceasefire so the war can end. Some days he sounds deeply sad, other days he speaks with fight in his voice. “Maybe you hear that people of Gaza, they love death, or they know nothing except death,” he said by voice note in June. “But actually,” he told me, “we people of Gaza, we love life.”
Abed had loved her life before the war; being a mom, working with her husband on building their own graphic design company as they saved for a house. Alreqeb loved his life, too: watching romantic movies with Issra at home, taking his daughter to restaurants, bringing life into the world without bombs. His tent clinic, he said, is the seed of a larger idea; he wants to build his own maternity hospital after the war, when all of Gaza is rebuilding—and being reborn.
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PHOTOS: GETTY, INSTAGRAM @MIDWIFE.IN.PINK.SCRUBS, SALMA HELMI AWNI KADDOUMI, HUSSEIN OWDA/UNRWA
husband, he said this was no time to have a child, but they would manage, somehow. They had fled their home in Gaza City when Israel declared war on Hamas, the militant group that controlled Gaza and which had launched a surprise attack on Israel last October, killing some 1,200 people. An Israeli rocket tore through the Abeds’ apartment building soon after. Abed, her husband, and three-year-old son took refuge with extended family in central Gaza, with 19 people sharing one apartment. She prayed the war would end before she gave birth.
For months, Abed, 29, could not find a doctor or midwife for her prenatal appointments because so many hospitals in Gaza were bombed out or closed. So she turned to her mother for advice; she fretted that she wasn’t getting the prenatal vitamins or nutrition she needed. The family lived on canned beans and the occasional vegetable. There was no fruit, meat, or fish. She fainted multiple times due to the poor diet and vomited from contaminated water.
Anytime Abed imagined her baby’s future, she panicked, worrying about what would happen if she couldn’t breastfeed and formula wasn’t available, or if she was killed and her baby orphaned, as by the spring 19,000 children would be. Her young son had lived through multiple conflicts with Israel, but “these were like escalations, they were not wars,” she said. “I just don’t want to see my baby suffering the way people are suffering here.” She dreamed of giving birth in peacetime, when she could provide her child with mangos, cucumbers, and bananas.
By summer, the death toll of the war was staggering; the medical journal The Lancet estimating that in July 2024 between seven and nine percent of the population of the Gaza Strip had been wiped out. Some half of all deaths were women and children.
husband, he said this was no time to have a child, but they would manage, somehow. They had fled their home in Gaza City when Israel dn of the Gaza Strip had been wiped out. Some half of all deaths were women and children.
said this was no time to have a child, but they would manage, somehow. They had fled their home in Gaza City when Israel declared war on Hamas, the militant group that controlled Gaza and which had launched a surprise attack on Israel last October, killing some 1,200 people. An Israeli rocket tore through the Abeds’ apartment building soon after. Abed, her husband, and three-year-old son took refuge with extended family in central Gaza, with 19 people sharing one apartment. She prayed the war would end before she gave birth.
For months, Abed, 29, could not find a doctor or midwife for her prenatal appointments because so many hospitals in Gaza were bombed out or closed. So she turned to her mother for advice; she fretted that she wasn’t getting the prenatal vitamins or nutrition she needed. The family lived on canned beans and the occasional vegetable. There was no fruit, meat, or fish. She fainted multiple times due to the poor diet and vomited from contaminated water.
Anytime Abed imagined her baby’s future, she panicked, worrying about what would happen if she couldn’t breastfeed and formula wasn’t available, or if she was killed and her baby orphaned, as by the spring 19,000 children would be. Her young son had lived through multiple conflicts with Israel, but “these were like escalations, they were not wars,” she said. “I just don’t want to see my baby suffering the way people are suffering here.” She dreamed of giving birth in peacetime, when she could provide her child with mangos, cucumbers, and bananas.
By summer, the death toll of the war was staggering; the medical journal The Lancet estimating that in July 2024 between seven and nine percent of the population of the Gaza Strip had been wiped out. Some half of all deaths were women and children.
(Photo credit: Shutterstock)
n the 10th day of the war, Safa Abed learned she was pregnant, and cried. When she told her husband, he
O
Lesser known is the story of birth taking place amid so much death, with about 180 babies being born in Gaza every day. Mostly, it is a story of extreme hardship—a maternal health crisis where nearly every mother is malnourished like Abed, leading to preterm and low birthweight babies, miscarriages and stillbirths; women who cannot reach the few remaining hospitals to give birth due to the danger, so they deliver unsafely at home or in tents; gender-based violence against birthing women on the rise, spurred on by all the stress; serious infections in both mother and child; postpartum hemorrhaging of the mother, sometimes leading to death; and nearly every woman suffering from post traumatic stress—trauma they pass on to their babies.
Juliette Touma of the United Nations Relief and Works Agency (UNRWA), one of the main UN agencies providing emergency humanitarian aid to Gaza, said that she has worked in conflict zones for decades, and never seen a crisis of this magnitude. “I tell you, it’s probably one of the most difficult places on earth to be a woman,” she said, especially a woman who is pregnant. But it is also a story of heroism, of the doctors, midwives, and other healthcare staff who are delivering babies and caring for birthing women amid tanks and bombs and gunfire; who are continuing to work despite having lost homes and belongings and loved ones themselves. As Touma puts it to me: “How do you care for someone when you yourself need help?”
(Photo credit: Lorem ipsum)
Of Gaza’s 36 hospitals, the majority were bombed, raided, or shut. Hundreds of healthcare workers were killed, while others fled the region. The remaining OB-GYNs, midwives, and nurses worked long hours in barely-functioning labor and delivery units or makeshift tent clinics with few supplies in chaotic conditions, the sound of explosions and gunshots around them, and the fear they could be raided at any time.
Maternal healthcare workers knew the war would be disastrous for birthing women and their babies. Yet Mohammed Alreqeb, M.D., an OB-GYN who was living with his family in Khan Younis in the south of Gaza when the war began, said that what has happened since was “beyond my worst dream.”
When he was displaced to Rafah, also in the south, he set up an emergency maternity tent clinic there, where he said he “was forced to deliver many babies with no equipment and very simple and old techniques.” With no cord clamp for the umbilical cord, he used thread, and with no sterile knives, he used a kitchen knife or scissors. “I never expected to face such extreme conditions,” he said. But with around 155,000 pregnant and breastfeeding women in the Strip, any maternity care was desperately needed.
Providers said many women didn’t want to get pregnant during the war but birth control was difficult to find. Or, like Abed, they learned they were pregnant just as the war began. Alreqeb said some women were doing medical abortions by pill, but it was illegal in Palestine, so most opted not to. As a result, some 20,000 babies have been “born into hell,” as UNICEF said in January.
(Photo credit: Lorem ipsum)
Malak Abu Sultan, a 22-year-old woman the United Nations Population Fund (UNFPA) interviewed, described the health issues that plagued her baby boy ever since she gave birth to him during the war: His eyes were swollen and red from lack of sleep and humidity, and he’d developed a dry cough and cold from the smoke of nearby fires. Sometimes, he turned blue from coughing due to phlegm. Sultan was too afraid to travel to the hospital for help, “so I’m basically his doctor,” she said.
Flies bit them all the time. At night, they were kept up by airstrikes. When they hit, Sultan’s baby often hugged himself. “A four month old [who] understands what airstrikes are?” she said, more of an outraged question than a statement.
Alreqeb tried to reach as many women like Sultan as he could with his maternity tent clinic. Since 2017, he’d worked as an OB-GYN at Nasser Medical Complex, one of the largest hospitals in Gaza, but it had been closed for months after the Israeli Defense Forces (IDF) struck it multiple times and then raided it in February 2024, claiming that the dead bodies of the hostages were there. The raid killed three of Alreqeb’s immediate colleagues and caused the hospital to run out of food, water, electricity, and oxygen for patients.
(Photo credit: Lorem ipsum)
ver the next few months, as Abed’s baby grew, the maternal healthcare situation in the Strip grew dire.
O
Alreqeb spoke to me over WhatsApp in June after a 24-hour shift at a hastily rebuilt and reopened Nasser Medical Complex. Israeli forces were still laying siege nearby, so he and just four other doctors delivered nearly 80 babies amid screams of fear and pain as the building shook from nearby bombs. The ward was so overcrowded with birthing women and the general wounded, he said, “that we don’t have any chance to raise our heads and see the patient. We just work, work, work.” Alreqeb took one break that shift to eat a small meal of bread and cheese before going home to his nearby tent. It was the latest place he was sheltering after being forced to flee seven times. Nine out of 10 Gazans are internally displaced.
Over the next few weeks, Alreqeb sent regular updates from Nasser Medical Complex: a video of the packed and chaotic waiting room, a photo of himself in worn scrubs, with a half-smile and eyes red with exhaustion, and a photo of a chubby boy he’d delivered healthy. This is what keeps him going, he said—the joy in women’s faces when they meet their babies for the first time. “That happiness is very unique,” he said. “And that gives me much happiness, actually.”’
A UNRWA midwife in central Gaza told a similar story of a pregnant woman who came into her clinic during the war and, upon hearing that her baby had a heartbeat, “instinctively hugged me in sheer happiness.” Like Alreqeb, she’d found that there was some joy that war could not steal.
had become even more difficult to obtain. There were no diapers and, though the family wasn’t poor—she and her husband were both graphic designers before the war—baby clothing was wildly expensive.
But Abed had a more pressing concern: where she’d give birth. Shuhada al-Aqsa Hospital, the main hospital in central Gaza, had become a “martyrs hospital” to receive the wounded and the dead. The other nearby option was a private hospital called Al-Awda, but it was beside a refugee camp that the IDF regularly targeted, so it was dangerous to deliver there.
Abed had developed a “phobia” of delivering a baby under the circumstances, meaning possibly in a tent or at home, with no doctor or midwife to help her. “I’m in the 39th week of my pregnancy. That is one week away,” she said in a WhatsApp call, her lilting voice faltering a little. “I am very afraid of a ground invasion… I am very panicked about delivering a baby at home… And I am scared that the malnutrition that is spreading in the Gaza Strip will affect me and my baby’s health.”
According to the humanitarian agency CARE International, women were three times more likely to die in childbirth or miscarry than before the war, so Abed knew she or her baby might not make it.
Meanwhile, in Vancouver, Canada, more than 6,000 miles away, a 37-year-old midwife named Heba Al-Nashef scrolled through the terrible images from Gaza on social media, and told herself she had to do something. Al-Nashef is of Arab heritage, and she had long wanted to assist on a medical mission. “So eventually it was just, let’s go, like I can do it, I don’t have an excuse not to,” she told me by video call, her tone matter-offact. “I can help my people during a genocide.”
(Photo credit: Lorem ipsum)
To get to Gaza, Al-Nashef traveled from Canada to Jordan to the Karam Abu Salem border crossing between Israel and Gaza. She went as part of a United Nations delegation, with support from the medical supplies company Glia, taking leave from her various jobs, including her clinical practice and administrative position as the assistant head of midwifery at St. Paul’s Hospital in Vancouver.
Driving into Gaza in June, Al-Nashef said, the scene was “apocalyptic.” She passed entire towns of gray rubble with no one on the streets, “empty and all destroyed, like a game with zombies.” Finally, Al-Nashef arrived at Al-Awda Hospital in northern Gaza, where ambulances with the wounded regularly pulled up and where she’d be assisting as a midwife in labor and delivery.
When we spoke over WhatsApp during her first week in Gaza, the lights went out behind Al-Nashef in the dorm where she was staying before a generator kicked in. Her voice was hoarse, her dark hair pulled back in a ponytail. Like Alreqeb, she said the shortage of supplies was a major issue for their maternity staff. They didn’t have the right sutures for women sometimes, or enough CPAP machines for respiratory support, or safe umbilical cord clamps for the babies. Some midwives were using the lace of a mask, soaked in alcohol, to wrap around the umbilical cord to stop it from bleeding.
“A woman welcoming a baby
to this world is supposed to
be a gentle experience,”
Al-Nashef said. In Gaza, it is dangerous and chaotic.
y June 2024, when Safa Abed was nine months pregnant, her belly swollen and energy sapped, food
B
In describing the scene of the births in her first few days, Al-Nashef said: “It’s 35 degrees [Celsius], with a hot sewage smell, and no clean running water. When a woman pushes and you see the head, [only] then do you bring them downstairs.” In the delivery room, a woman often had to give birth with three other women beside her, their cries filling the room. Vaginitis, an infection that could lead to extended tearing, was rife. As a result, staff were regularly doing episiotomies on women—a painful, mostly outdated practice that involves making a cut in the area between the vaginal opening and anus. Al-Nashef said this was not evidence-based but it was her job to help, not lecture, the staff.
Once the baby was born, there were no sheets to absorb the amniotic fluid or dry the baby, she went on, so they used diapers instead. Since every birthing woman was also anemic from malnutrition, they were at a high risk of postpartum hemorrhaging, which could be fatal. Even if a woman didn’t hemorrhage, there was little time for the important, intimate practice of skin-to-skin contact between a new baby and their mother. “A woman welcoming a baby to this world is supposed to be a gentle experience,” Al-Nashef said. In Gaza, it is dangerous and chaotic.
Al-Nashef's first day at Al-Awda Hospital had begun normally enough, with an orientation with the head of OB-GYN. Then, bombs went off outside and the building began shaking. It was early June, and the IDF was conducting a daytime raid on the Nuseirat refugee camp next door, during which it rescued four of the remaining 116 hostages Hamas had been holding—while also killing at least 274 Palestinians according to the Gaza Health Ministry. Soon, the wounded and the dead bodies started coming in on stretchers to the hospital.
“It was a horrific scene,” Al-Nashef said. “A massacre.” That first night, a pregnant woman came into the hospital around seven or eight centimeters dilated, “crying and crying” in a way that seemed beyond the usual cries of pain during labor, Al-Nashef said. It turned out that her husband and five children had all been killed in the raid. After the woman’s baby was delivered, she and the staff had to quickly move on to the next patient. “Dwelling on it doesn’t serve the people that I’m supposed to serve,” she said. Every one of Al-Nashef ’s colleagues, she adds, was “overworked, overstretched but was not complaining. They just do the work and go back to their tent or dorm,” sleep, and wake up to face life—and death—again the next day.
(Photo credit: Lorem ipsum)
told me, quietly. He explained that he and his wife and daughter had lost their home, their belongings, their savings, as well as dozens of relatives and friends. Alreqeb’s wife had learned she was pregnant before the war started. All the displacement had been especially hard on her; fleeing first from their apartment in Khan Younis to a former school-turned-shelter, then another, and another. For a month, they lived inside Nasser Medical Complex where Alreqeb worked, before having to flee from there.
In January 2024, Alreqeb said, he, his wife, and their three-year-old daughter, Mariam, were on the move again, out of Khan Younis because Israel was escalating its ground invasion there. Their destination was Rafah, just six miles away but hours on foot with no available vehicle or fuel.
The day was bitterly cold and rainy, and Alreqeb remembers carrying their bags and Mariam in his arms, while making jokes to try to cheer up a 35-weeks-pregnant Issra. Thousands of other Gazans accompanied them on the grim march to Rafah. At one point, Alreqeb recalled, Israeli tanks were so close they could see them. “If they wanted, they could kill us. But Allah must have had us,” he said. Eventually, he convinced a man to put Issra on a donkey cart.
When they made it to a tent in Rafah, Issra suddenly began having contractions. Alreqeb was sure she was in preterm labor because of stress. The nearby Al-Helal Al-Emirati Maternity Hospital in Rafah was open and packed. The electricity was going on and off in the labor ward. Only a couple midwives were on duty for nearly 30 women in labor. Alreqeb worried about the unsanitary conditions for both Issra and the baby.
After five hours, when the baby crowned, Alreqeb realized he was going to have to deliver the baby himself, which worried him because “usually the person who is a doctor to their own family makes the wrong decision.” But he safely delivered their baby girl, who they named Salma, which means “safe and sound.”
Salma came out with a cleft lip, which Alreqeb attributed to his wife’s exposure to toxic gasses and chemicals during the war. Otherwise, she seemed healthy and they left the hospital to go home. Within two days, they were back. Salma was sleeping too much and refusing to feed. Alreqeb realized she had pneumonia, which could be fatal if she developed sepsis. He managed to secure an incubator for Salma but the hospital said it would need to add more babies soon, which could give Salma another infection. So he took her into his and Issra’s arms, gave her antibiotics, and prayed.
Of Gaza’s 36 hospitals, the majority were bombed, raided, or shut. Hundreds of healthcare workers were killed, while others fled the region. The remaining OB-GYNs, midwives, and nurses worked long hours in barely-functioning labor and delivery units or makeshift tent clinics with few supplies in chaotic conditions, the sound of explosions and gunshots around them, and the fear they could be raided at any time.
Maternal healthcare workers knew the war would be disastrous for birthing women and their babies. Yet Mohammed Alreqeb, M.D., an OB-GYN who was living with his family in Khan Younis in the south of Gaza when the war began, said that what has happened since was “beyond my worst dream.”
When he was displaced to Rafah, also in the south, he set up an emergency maternity tent clinic there, where he said he “was forced to deliver many babies with no equipment and very simple and old techniques.” With no cord clamp for the umbilical cord, he used thread, and with no sterile knives, he used a kitchen knife or scissors. “I never expected to face such extreme conditions,” he said. But with around 155,000 pregnant and breastfeeding women in the Strip, any maternity care was desperately needed.
Providers said many women didn’t want to get pregnant during the war but birth control was difficult to find. Or, like Abed, they learned they were pregnant just as the war began. Alreqeb said some women were doing medical abortions by pill, but it was illegal in Palestine, so most opted not to. As a result, some 20,000 babies have been “born into hell,” as UNICEF said in January.
ver the next few months, as Abed’s baby grew, the maternal healthcare situation in the Strip grew dire.
O
her contractions started, she left home, but chose not to go to Al-Awda Hospital because of the danger. Instead, she went to a tent clinic newly set up in central Gaza by the International Medical Corps. Pain relief was not available for her eight-hour delivery, so she had to work through excruciating contractions. Against all odds, her baby boy was born healthy. She named him Yamen, which meant “generosity and ease,” something she longed for.
Abed stayed at the hospital for just a few hours after the birth and then went home because there wasn’t space to keep women for long. There, she groaned in pain and bled for days. But she was able to breastfeed, and Yamen thrived. Food was scarce but enough. She imagined a better future, of taking him to schools and parks and restaurants. Of having ease again.
At Al-Awda Hospital, Al-Nashef was nearing the end of her six-week medical mission. When a bomb went off, she instinctively knew to jump away from the glass because the IDF usually struck a second time. One of her fellow midwives had nearly lost her arm to shrapnel. She'd spoken to young boys who acted like men, including one who held his brother in pieces. She'd watched as more women gave birth to preterm babies, like Alreqeb’s wife had, likely from the stress of war.
One day in July, Al-Nashef heard a drone outside the hospital that she thought was a “zenana,” which means “buzzing” in Arabic—an IDF drone that is loud on purpose to let people know they’re under surveillance. But it was a quadcopter, a far more terrifying drone with four rotors that can kill people at close range. Al-Nashef was helping a woman push out her baby when the quadcopter started shooting. The woman panicked. “I said, ‘Forget about it, no one is coming close, just have the baby,’” Al-Nashef said. “I’m suturing her and hearing the firing, trying to calm her down, and you just have no idea what’s going on.”
Where before her colleagues were overworked, now “they are holding on by a thread,” she said. “They went to work, helped people have their babies…but they’re so exhausted, they kind of dissociate.” When Al-Nashef finally left Gaza for home, she immediately began thinking about returning later this year. She struggled with guilt at having left her colleagues behind. “Something about Gaza takes a piece of your heart and leaves it there,” she said.
In Cairo, Alreqeb’s daughter, Salma, received a much-needed surgery. Between shifts at the hospital, Alreqeb speaks to his wife and daughters over WhatsApp as often as he can. All he wants, all any ordinary person in Gaza wants—the mothers, the humanitarian agencies, the doctors and midwives—is a ceasefire so the war can end. Some days he sounds deeply sad, other days he speaks with fight in his voice. “Maybe you hear that people of Gaza, they love death, or they know nothing except death,” he said by voice note in June. “But actually,” he told me, “we people of Gaza, we love life.”
Abed had loved her life before the war; being a mom, working with her husband on building their own graphic design company as they saved for a house. Alreqeb loved his life, too: watching romantic movies with Issra at home, taking his daughter to restaurants, bringing life into the world without bombs. His tent clinic, he said, is the seed of a larger idea; he wants to build his own maternity hospital after the war, when all of Gaza is rebuilding—and being reborn.
her contractions started, she left home, but chose not to go to Al-Awda Hospital because of the danger. Instead, she went to a tent clinic newly set up in central Gaza by the International Medical Corps. Pain relief was not available for her eight-hour delivery, so she had to work through excruciating contractions. Against all odds, her baby boy was born healthy. She named him Yamen, which meant “generosity and ease,” something she longed for.
GIVING
Procedures performed with kitchen scissors. Makeshift medical tents with no pain medication, clean water, or electricity. Marie Claire goes inside one of the most dangerous places in the world to be pregnant right now.
BY ELIZABETH FLOCK
BIRTH
IN GAZA
“I just don’t want
to see my baby suffering the way people are
suffering here.”
—Safa Abed
According to the humanitarian agency CARE International, women were three times more likely to die in childbirth or miscarry than before the war.
“I said, ‘Forget about it, no one is coming close, just have the baby.’ I’m suturing her and hearing the firing, trying to calm her down, and you just have no idea what’s going on.”
“I just don’t want to see my baby suffering the way people are suffering here.”
“I just don’t want to see my baby suffering the way people are suffering here.”
This story appears in the 2024 Changemakers Issue of Marie Claire.
n June 24, 2024, on the 262nd day of the war, Safa Abed finally gave birth. A few hours after her
—Dr. Mohammed Alreqeb
—Heba Al-Nashef
—Safa Abed
—Safa Abed