Wombs in the crossfire: the impact of war on reproductive health and fertility in Gaza: a narrative review

Abstract Background Armed conflicts devastate healthcare systems, yet the impact on reproductive health remains underexplored. The war in Gaza has destroyed hospitals and fertility centers, leaving women without essential maternal and fertility care. Objective To examine the impact of war on reproductive health in Gaza, focusing on maternal care disruption, fertility service destruction, and reproductive rights violations. Methods A narrative review of peer-reviewed studies, humanitarian reports, and testimonies was conducted. Sources included UN agencies, WHO data, medical journals, and accounts from healthcare professionals and affected patients in Gaza. Results Over 84% of health facilities in Gaza have been damaged or destroyed. About 155,000 pregnant and breastfeeding women face barriers to care, with 68% reporting complications such as anaemia, hypertension, and preterm labour. Fertility centers were targeted, destroying over 5,000 embryos and halting assisted reproductive technology (ART) services. Women described severe psychological trauma from the loss of reproductive material, compounded by malnutrition, overcrowding, and lack of privacy in shelters. Conclusion The war has precipitated a reproductive health crisis in Gaza, posing both medical and social challenges. This narrative review highlights the urgent need to safeguard maternal and fertility care in conflict zones through international protection, accountability, and the implementation of innovative emergency service delivery strategies. The study integrates multiple data sources, offering a comprehensive overview of the medical, social, and emotional consequences of disrupted fertility services.