A doctoral candidate launched an organization shortly after the onset of the Israel-Hamas war to help pregnant and postpartum Palestinian women from afar.

In October, anthropology doctoral candidate Ferhan Güloğlu founded the Safe Birth in Palestine Project — a group of childbirth professionals, including doctors and midwives, working across the globe to offer virtual medical assistance and deliver aid to expecting and new mothers in Gaza after the start of the war. Güloğlu said the project’s strategies to reach pregnant and postpartum women in Gaza with supplies like food and medicine are constantly shifting as the Israeli military has blocked the entrance of aid to Gaza and killed aid workers in airstrikes, limiting Gaza’s access to humanitarian assistance.

In Gaza, 40 percent of pregnancies are high-risk, prenatal care is almost nonexistent and women are often forced to give birth outside of medical facilities. Doctors and aid workers have said miscarriages and stillbirths have spiked since Israel began its military campaign in Gaza in October.

“The situation is so dire that I felt compelled that we need to undertake some work,” Güloğlu said.

Many Palestinian women have considered fertility as part of their resistance efforts against Israel, which Güloğlu said prompted her to work to safeguard pregnant women in Gaza. Güloğlu said in the days following the onset of the war, she initially worked to send OB-GYNs and midwives from the U.S. into safe zones in Gaza but quickly realized there were no safe zones and that the entry of childbirth personnel was impossible.

“It’s horrific beyond words,” Güloğlu said.

She said she then contacted her academic networks and connected with maternal health organizations in Turkey, where she’s originally from, like the Turkish Maternal Mental Health Awareness Alliance. She said the Turkish organizations have teams headquartered in Gaza, allowing her to create the Safe Birth in Palestine Project and begin sending medical supplies like insulin into Gaza.

At the start of the war, the United Nations estimated that there were 50,000 pregnant women in Gaza, with more than 180 women giving birth every day. Nearly 60,000 pregnant women in Gaza suffer from malnutrition, dehydration and lack of proper health care, according to the Gazan Health Ministry and UNICEF estimates that 20,000 infants in Gaza need formula.

She said the group first put together a document in Arabic with instructions for Palestinians to conduct emergency unassisted childbirth, connected with Palestinian doctors to produce videos delivering the instructions and dispersed the videos via WhatsApp lines. She said the WhatsApp communities also allow Palestinian women to reach doctors who can provide medical advice via telehealth. Since October, roughly 190 women have used the group’s services, she said.

Güloğlu said the project fundraises via GoFundMe campaigns spread on social media and events like fundraiser dinners to send medical supplies into Gaza through its border with Egypt. But sending aid to Gaza has become increasingly challenging as the war progresses, she said.

Intricate Israeli military inspections force aid trucks to sit in miles-long lines. United Nations officials said Israeli authorities have rejected critical medical supplies like water filters and scissors because they said they could be used for military purposes.

Israel has attacked Palestinian officers delivering aid since the start of the war. Last week, humanitarian aid organizations suspended operations in Gaza after Israeli airstrikes killed seven World Central Kitchen workers.

She said the Safe Birth in Palestine Project has accordingly changed how they shepherd supplies through the border, as long inspections led to food and medicine like insulin perishing and becoming unusable. She said volunteers in their organization are currently traveling to the region with supplies in their luggage to avoid the inspection lines.

“It’s been really challenging, but every second it gets worse,” Güloğlu said. “In any moment when I say this can’t get any worse, it did.”

Güloğlu said she’s had to tell some women that the project doesn’t have the means to help them, like one woman she spoke to last week living in northern Gaza, where the majority of Israel’s bombardment takes place, who required a cesarean section. She said the group did not have the means to transport her to the south of Gaza for medical care, meaning she is susceptible to a uterine rupture, putting the mother at risk for severe blood loss and the baby at risk for brain damage or suffocation.

“It’s not a story of success, but an epic failure and disappointment,” Güloğlu said.

Güloğlu said women have given birth safely due to the program and their babies have since been killed in the violence. She said her work with the Safe Birth in Palestine Project has been emotionally and mentally draining.

Despite the grave circumstances, she said she’s gained a new resilience from speaking with Palestinian women and hearing their success stories of safe births.

“You hear about a successful childbirth, a healthy baby, a woman who just got food or a shot that she needed, formula. Through all these telehealth processes she’s able to breastfeed successfully, like it’s all worth it,” Güloğlu said.

Experts in OB-GYN care during conflict said while emergency medical advice and delivering aid are helpful, structural changes like ensuring the presence of formal health care facilities are needed to preserve maternal health in Gaza.

Ribka Amsalu, a research fellow at the University of California, San Francisco, said during conflicts, pregnant women lack access to information, so helping from afar is effective in establishing networks of communication for women to access health care advice and to ask questions to medical professionals. She said in Gaza, health care facilities that still exist have to prioritize caring for those injured in the war.

“This diversion of resources should be taken into account when caring for a pregnant woman,” Amsalu said.

Dabney Evans, an associate professor of global health and the director of the Center for Humanitarian Emergencies at Emory University, said pregnant women are especially vulnerable to risks that all civilians in Gaza are facing like lack of access to water, food and supplies for medical care and services.

“We have international structures that are designed to help in the case of complex humanitarian emergencies and that includes food, water, shelter, nutrition and health,” Evans said. “We really just need to make sure that those are activated and actually functioning, regardless of what the political situation is.”