Content warning: The following statement contains disturbing statistics, information, and imagery. While we encourage connection to our global community in an effort to motivate collective action to end genocide, secondary trauma has real, lasting effects especially during pregnancy, and therefore especially discourage pregnant people from reading any further.
Women, birthing people, and infants disproportionately feel the impacts of violence, war, and atrocity crimes like genocide. The more we know from epigenetics, the more we know that this is not only the acute devastation of death, disease, and the direct trauma of living in a warzone, but that these effects – even of secondary trauma of simply witnessing this devastation – persist across the lifetime and across multiple future generations. Nurturely, as an organization committed to equity in perinatal wellness, recognizes that local perinatal equity will not be achieved without a global end to human rights abuses.
The Nurturely team feels the devastation echoing around the world as the global community has witnessed the recent loss of life and severe human rights violations against civilians – many of whom are women and infants – of Palestine, The Democratic Republic of Congo, Ethiopia, Haiti, Sudan, and Ukraine. These recent atrocities add to the long list of international human rights abuses during the past century including to Tutsis and moderate Hutus in Rwanda, the people of Cambodia, the Herero and Namaqua people of Namibia, the Rohingya of Burma/Myanmar, the Jewish population of Europe, the people of Armenia, and Bosniak Muslims of Srebrenica. These global human rights violations, genocidal attacks, and acts of atrocious violence are felt disproportionately by pregnant people and infants both locally and globally.
Here in the US we still live, despite our collective failure to acknowledge it, with the consequences our history of genocide and enslavement. So much of the work Nurturely and our partners do everyday is in response to the lasting harms in perinatal health from these unaddressed massive crimes against humanity. Just last week the CDC announced that the neonatal mortality rate has increased, with the rate of mortality for Black and African Americans still significantly higher than all other groups and with the mortality rate increasing significantly (21%) for Indigenous Americans.
Death & Devastation
In Ethiopia, recent reports document that entire families have been killed and relatives have been forced to watch horrific crimes against their loved ones. Since November, this escalated violence in Ethiopia has included mass killings, rape, starvation. In Gaza, as one example, Ministry of Health Data reported by the World Health Organization confirms that the majority of deaths have been women and children, representing 67% of the casualties as of November 3rd. Photos have circulated of newborn infants dying as they are removed from incubators that have lost power are just one particularly grim example of the many ways that living in a warzone affects reproduction and perinatal health. In Sudan, independent military group Rapid Support Forces has reached El Fasher, the only major city in the Darfur region still outside its control. Civilians in El Fasher fear for the worst as the RSF and allied Arab militias have deliberately executed civilians, raped women, looted and burned towns, and targeted hospitals. The Economist reports on the genocide in Sudan: “When they saw her 15-month-old son strapped to her, they shot him dead as he clung to her. The bullet burst through his tiny body and into hers, where it remains lodged.”
Almost 780,000 individuals and families fleeing war are being hosted by UNRWA, seeking protection and safety, although more than 60 of the 150 United Nations facilities have been impacted by attacks and 10 have been directly hit. Early assessments from UNRWA estimate 12,000 cases of diarrhea and 22,500 cases of acute respiratory infection among infants displaced as war victims. As both of these can be prevented with exclusive human milk feeding directly from the body, the importance of global, preventative, systemic support for lactation is one critically supportive mechanism in an overall dire situation. In Ethiopia, whole communities have been displaced or expelled from their homes and have been separated from resources due to the destruction of schools and medical facilities and arbitrary detention. Often displacement camps are the target of further attacks, which has been the case in Sudan where the killing and raping of many internally displaced people has been rampant.
Even before the current attacks, infants, children, and families were at the center of ongoing attacks and human rights violations, with the majority of children experiencing both personal trauma, as well as experiencing secondary trauma by witnessing the trauma of others. In pregnancy, no matter how far away the direct trauma is being felt, the stressful experience of witnessing or imagining such trauma can have irreversible effects. Through epigenetic mechanisms of gene expression that are shaped by the environment, these effects of war are transgenerational, being felt for generations to come.
Global <> Local Connection
Pregnancy, birth, and postpartum are global, universal, and deeply cultural human experiences. Achieving perinatal health equity requires not only local activism and change, but a feeling of deep connectedness to places directly impacted by country-wide war and genocide. Genocide is a reproductive justice issue and will not end without global demands for action.
Healthcare & Birthworkers
Living in a warzone with the effects of displacement, lack of clean water, blackouts, and lack of access to food and medicine, perinatal care is disrupted if not completely nonexistent. The estimated 50,000 pregnant people in Gaza are forced to deal with not only the psychological trauma of living in fear and rubble but also must deal with the physical complications of this lack of access. In Gaza, it is estimated that 180+ parents give birth every day, turning childbirth into a life or death scenario. The few hospitals that are open are operating in fear, as some hospitals have been directly targeted by attacks. The toll of this warzone on birthworkers and all people providing services to infants, parents, and families cannot be overestimated. Birthworkers and healthcare providers have a long history of the heroic labor of providing direct support in situations where their own lives and livelihoods are directly compromised.