Executive Summary
After Hamas’ brutal October 7, 2023 attack on Israel, subsequent Israeli military operations in Gaza have caused devastation and displacement. Beginning early in the conflict, humanitarian actors and civil society raised significant concerns about the likely impact on the health and survival of pregnant women1 and infants – two groups granted specific protection during armed conflict.2 The UN Independent International Commission of lnquiry on the Occupied Palestinian Territory, including East Jerusalem, and Israel (UN COI) reviewed evidence through July 2025 and found that Israel’s attacks on facilities providing reproductive health care and restrictions on food and medical supplies were intentional and systematic and resulted in devastating harm to the reproductive capacity of people in Gaza.3
This report affirms the UN COI’s findings and presents new evidence of the continued and worsening harms of the conflict on pregnant and postpartum women and infants from January through October 2025. The report analyzes how the health impacts of (i) attacks on health care facilities, (ii) restrictions on humanitarian aid, and (iii) acute malnutrition have translated into violations of the rights of women and infants in Gaza and constitute reproductive violence in violation of international law. Finally, drawing on this evidence, the report outlines urgent recommendations to ensure that people in Gaza receive adequate medical care and nutrition assistance, accountability, and justice.
Despite these reports, throughout early 2025, Israel continued to restrict access to humanitarian aid in Gaza.4 This occurred through a complete humanitarian aid blockade from March to May 2025, the subsequent introduction of the humanitarian aid distribution mechanism, the Gaza Humanitarian Foundation (GHF). which was widely critiqued as “engineered scarcity”,5 and despite the ceasefire reached in October. Following repeated warnings issued by the Integrated Food Security Phase Classification (IPC). famine ‘with reasonable evidence’ was finally determined in Gaza in August 2025.6
Between May and June 2025, the Palestinian Ministry of Health reported a 41 percent decrease in birth rate in Gaza compared to the same time period in 2022; there was a significant increase in miscarriages that affected more than 2,600 women, and 220 pregnancy-related deaths that occurred before delivery. 7 The ministry also reported a sharp increase in premature births and low birth weight cases; over 1.460 babies were reported to be born prematurely, while more than 2,500 were admitted to neonatal intensive care. Newborn deaths also increased, with at least 21 babies reported to have died on their first day of life.8 However, due to the near-complete collapse of Gaza’s health information system after October 7, 2023, systematic data collection was severely limited, making it likely that these numbers represent a significant undercount. Even since the ceasefire was reached these conditions continue; in October 2025, UNICEF reported that they identified 9,300 children under five years of age with acute malnutrition and that 8,300 pregnant and breastfeeding women were admitted to health facilities for treatment for acute malnutrition.9
In this study, Physicians for Human Rights (PHR) and the Global Human Rights Clinic at the University of Chicago Law School (GHRC) assess the foreseeable risks to pregnancy and neonatal health posed by these developments and examine the impact of attacks on health and restrictions on food and medical supplies on women of reproductive age, including those trying-to-conceive as well as pregnant, postpartum, and lactating women, and newborns from January to October 2025 when a ceasefire was signed
The destruction of Gaza’s health infrastructure, combined with restrictions on food and medical supplies including baby formula, has created an environment in which the fundamental biological processes of reproduction and survival have been systematically destroyed, resulting in known and foreseeable harm, pain, suffering, and death.
Analyzing 78 testimonies of international health care providers who worked in Gaza on short-term medical missions, this report documents the maternal and neonatal deaths, physical and mental suffering, and infertility experienced because of the compounded impacts of malnutrition and the inability to access reproductive health care supplies and services. To determine the foreseeability and preventability of these harms, PHR and GHRC reviewed these accounts against the record of warnings issued concerning risks to reproductive capacity as a result of the tactics of war used in Gaza, 23 reports of attacks on reproductive health care facilities in Gaza from January to September 2025,10 and the established medical literature on the known reproductive harms resulting from acute malnutrition and denial of proper prenatal and postpartum care.11
The report link