Resistance is Fertile: No reproductive justice without freedom for Palestine

On 27 October, Raneem Hejazi was eight months pregnant when her aunt’s apartment was hit by an Israeli military airstrike. Unlike her aunt and six other family members, Raneem survived the strike, but her arm was crushed, and her legs were broken and badly burned. An ambulance managed to rush her to the overcrowded Nasser Hospital in Khan Yunis, in the South of Gaza, which is being deprived of electricity, water and antibiotics. Dr. Mohammad Qandeel decided that an emergency caesarean section was needed. With cell phones illuminating the operating table, the medical team managed to save the life of Raneem and baby Maryam -  for now, because with a critical lack of food, shelter and clean drinking water, it is unclear how Raneem and her family are supposed to survive, let alone live and thrive.

Sadly, Raneem’s dystopian birthing story is not unique. Israel’s brutal military assault on Gaza specifically targets health care and life-supporting facilities and by extension reproductive rights, health, and justice. According to the United Nations Population Fund (UNFPA), there are approximately 50,000 pregnant people in Gaza right now, of whom 5,500 are expected to give birth in the coming month. All of them are at grave risk amid unseen and atrocious levels of violence while medical care, food, and water are still largely blocked from entering the Gaza Strip. Lack of micronutrients produces a serious risk to pregnant and lactating people, especially to half of Gaza’s pregnant population that suffers from anemia. There are  acute shortages of antiseptics and of blood products for treating postpartum hemorrhage. The UN reports hysterectomies as a last resort to save pregnant people’s lives. C-sections are conducted without anesthesia, and laboring people are forced to give birth without pain relief. In many instances, pregnant women in labour are unable to access maternity care services, or are only admitted to the hospital at the very last moment before birth, and discharged again shortly after delivering. Often, mothers have no safe place to go, lacking access to clean water and food, which affects their ability to breastfeed and care for themselves and their newborns. With residential areas and medical facilities as central targets, women are forced to deliver their babies in cars, in the streets, and in overcrowded shelters where the risk of infection and the spread of disease is high. There is also a shortage of contraceptives and sanitary products needed for postpartum bleeding and periods. The World Health Organization (WHO) has stated that over half of Gaza's hospitals - 22 out of 36 - are now "non-functional" and recorded 335 attacks on health care in the occupied Palestinian territories since the start of the hostilities. It expects maternal and neonatal deaths to increase due to physical trauma, a rise in stress-induced miscarriages, stillbirths, and premature births, as well as general deterioration of health, and continuous lack of medical treatment.

According to the updates from 9 December, more than 18.000 Palestinians have been killed in Gaza so far since October 7, almost 8.000 of them were children, with an estimated 1.500 more reported missing and presumably trapped under the rubble. 18.000 Palestinian children are wounded and an estimated 25.000 have become orphans in the last two months. Also 33 of the 1.200 Israelis who were reportedly killed on October 7 were children, and 40 children were taken hostage by Hamas. All life is sacred, and humanity is not a numbers game. There are heartbreaking stories of unfinished love, life and dreams behind each of these losses. There is, however, a glaring disproportionality, between the loss of Israeli and Palestinian life, both in scale and in terms of power inequalities between a settler colonial, occupying, nuclear powered Apartheid regime and an occupied and besieged civilian population. And at the time of writing this killing is continuing.

This disproportionality is illustrative of the State of Israel’s systematic disavowal and dehumanization of Palestinian life. For every Israeli child that was killed on 7 October, 240 Palestinian children have been bombed by the Israeli armed forces, transforming Gaza into a “graveyard for children”, as UN Secretary General Antonio Gutterez phrased it, and as “the most dangerous place in the world to be a child” according to UNICEF Director Catherine Russel. In the occupied West Bank, Israeli security forces and settlers have killed an additional 53 Palestinian children since the start of the recent war. Hundreds of Palestinian children remain imprisoned in Israeli jails, often without charge, trial or due process guarantees, which does not meet international juvenile justice standards. According to Save the Children, Israel prosecutes between 500 and 700 children in military courts each year, and has detained more than 10.000 children over the past 20 years. 

Israel’s assault on Palestinian life and reproduction, did not start on October 7, but fits a decades old pattern of reproductive injustice. In 1948, Deir Yassin was one of the 531 Palestinian villages that was attacked by Zionist paramilitary groups during the Nakba [1], resulting in the killing of more than 100 Palestinian men, women and children, widespread looting, mutilation and torture. Since the early 2000s, Israel has intensified its regime of closures, forcing many Palestinian women to give birth at military checkpoints, as they are not allowed to pass to go to the hospital in time. The maternal mortality rate in Palestine, 28.5  per 100.000 live births, is eight times higher than in Israel, where it stands at 3.4. The infant mortality rates are almost five times higher in the West Bank and Gaza than in Israel. In 2013, the infant mortality rate was estimated at 15.8 per 1.000 live births in the occupied Palestinian territories, compared with 3.5 in Israel.

Israel is known internationally as having adopted remarkably pronatalist policies since its creation in 1948, aimed at encouraging high birth rates by offering financial incentives for reproducing large families, welfare benefits for (working) mothers, high child allowances and generous subsidies for assisted reproductive technologies including in vitro fertilisation, egg donation and surrogacy. However, critical scholars [2] have been arguing for decades that Israel’s pronatalism is selective, and mostly designed to benefit its European-descended Jewish Israeli citizens and not Palestinians who are framed as a “demographic threat”. Palestinians in the West Bank and Gaza are a priori excluded from benefiting from Israel’s ‘pronatalist’ reproductive policies. Palestinian citizens inside Israel are often restrained by colonial realities from exercising their reproductive rights equally, although legally speaking they are entitled to the same fertility treatments as Jewish Israelis [3]. Antinatalist actions were also documented against Ethiopian Jewish women in Israel who were disproportionately prescribed with the controversial contraceptive Depo Provera without their proper consent, and against Mizrahi, Yemenite and Balkan Jewish families upon settlement in Israel in the early 1950s, of whom thousands of babies and toddlers were reportedly  kidnapped and housed in transit and absorption camps.

The current and past wars on Gaza and Palestine at large illustrate how Israel’s “pronatalism” is not only stratified, but also bears strong necropolitical militarized logics. Israel’s health ministry is now implementing a posthumous sperm retrieval program, aimed at harvesting and preserving the sperm of deceased young males, particularly soldiers killed in battle. Israel’s Haaretz newspaper reports that the posthumous sperm retrieval program had, till November 9, been carried out on 33 men killed in Hamas’s cross-border raid on October 7, of which 29 were soldiers and four were civilians. Meanwhile, after the Gaza War in 2008, Israeli soldiers designed t-shirts portraying a pregnant Palestinian woman in the crosshairs of a gun, accompanied by the slogan: “One shot, two kills”. Similarly, during Israel’s war on Gaza in 2014, Gazan women were frequently portrayed as hyper-fertile and sexualised “breeders” that deserved to be annihilated because of their mere ability to bring forth the next generation of Palestinians. Also now, Palestinian women and children are bearing the brunt of the hostilities, with WHO and other UN agencies warning that they constitute almost 70 percent of all casualties. Yet, The Economist states that Gaza’s “high birth rates” and “unusual demographies” are to be blamed for the death toll of thousands of children, not the unfathomable amount of bombs that Israel has dropped on a entrapped civilian population.    

The intentional attack on present and future Palestinian life and reproduction has been termed a genocide in the making by scholarly experts and UN officials. This unfolding genocide is only the latest and most obvious iteration of Israel’s stratified pronatalist regime, which, according to critical scholarship [4], is sedimented in a century old Zionist settler colonial logic of demographic replacement, aimed at creating and maintaining a Jewish demographic majority in a Jewish state at the expense of Palestinian Indigenous life. Half of Gaza’s civilian infrastructure, including houses, refugee camps and entire neighborhoods, schools, universities, children’s nurseries, hospitals and other UNRWA facilities, mosques, churches and water and electricity infrastructure, has been targeted and wiped off the map. 1.9 million Gazans, most of them refugees from 1948, are currently displaced and unable to return to their homes, in what Palestinians call a second or ongoing Nakba. Many Israeli policy makers are openly calling for a complete annihilation and depopulation of Gaza, and a resettlement of Jewish Israeli settlers, which is illegal under International Law, yet condoned and supported by US and European governments. 

There has been a remarkable silence of academic institutions and researchers on this issue [5], also those involved in the broad study of reproduction, health, fertility, kinship, and parenthood. It is staggering to see how an essential pillar of genocide, namely the prevention of births and the transfer and the ethnic cleansing of an entrapped, displaced, starved, water-deprived population of 2.3 million facing massive bombardments, does not cause more uproar in the academic community of scholars interested in the epidemiology, sociology, anthropology, feminist theory, and philosophy of reproduction. This may be partly due to the strong victimisation of scholars and students who do speak out on Palestine, some of whom are being silenced or wrongfully accused of antisemitism. Organized teach-ins in some universities are being canceled, study material on Palestine is being censored, and additional bureaucracies and surveillance are introduced under the guise of “student wellbeing” and “sensitivity”. But this does not relieve us of our moral duty to fight for reproductive justice for all. 

Professional midwifery organisations also remain silent concerning the abhorrent conditions to which Palestinian women, children and reproductive health care workers are subjected. With the forced closure of Gaza’s main hospitals, Palestinian midwives have become a lifeline for pregnant people in Gaza. As the International Confederation of Midwives rightfully stated during the annual 16 days of activism against gender-based violence that ‘midwives are advocating for a world where violence against women and children is a thing of the past’, it must be urgent for all midwives to address the reproductive catastrophes unfolding in Gaza.

We fully endorse the statement by Palestinian feminist scholars and organizers that ‘Palestine is a feminist struggle’, and call on everyone involved in the study, practice and facilitation of reproductive justice – that is repro-scholars, abortion activists and providers, midwives, doulas, obstetricians and gynecologists – to stand in solidarity with the Palestinian people. We ask those committed to reproductive justice to “support the call for a permanent cease fire, lift the siege on Gaza, end the Israeli occupation, and dismantle the settler-colonial structure which has denied Palestinians their reproductive rights and freedom for over 75 years”. The reproductive justice framework, as established by Black feminists and women of colour since the mid-nineties, advocates for the right to have children, not have children, and raise children in safe and healthy environments. Genocide and colonial occupation are in direct violation of reproductive justice and should therefore be a matter of concern for all advocates for reproductive justice, health, and freedom. 

Reproductive justice means allowing all Palestinians, from the river to the sea, to build and rebuild the infrastructures of life and social reproduction they need to live a life worth living, free from bombs and colonial dispossession. There can be no reproductive justice when it does not count for everyone, Jewish and Palestinian people alike. There can be no reproductive justice without a free Palestine. Considering that many of us work in countries whose governments are explicitly complicit in the ongoing colonial occupation and genocide of Palestinians by offering moral, political and material support, the time to show unwavering solidarity with Palestinians in matters of life and reproduction, is now. Our resistance is fertile. Let us commit ourselves to continued protest. 

What you can do as a repro-scholar:

• incorporate Palestine, de/anticolonialism and intersectionality in your academic analysis and scholarly outputs on reproduction.

• co-organize classes, lectures and teach-ins on reproduction, feminism and Palestine

• invite Palestinian scholars to your conferences and symposia

• issue statements on solidarity with Palestine

• study the complicity of Israeli universities in reproductive injustice in Palestine, and support the Boycott, Divestment and Sanctions Campaign

• support colleagues who are being silenced, disciplined or sanctioned for speaking out on Palestine

What you can do as a midwife, doula, obstetrician or gynecologist:

• speak out as a  birth worker on the attacks on healthcare and healthcare workers and patients in Palestine

• call on your professional organizations to issue a statement of solidarity

• talk to your colleagues about reproductive health in Palestine

• organize with other reproductive care workers for a free Palestine

• organize to help with reproductive and maternity care in Gaza 

• speak out on Palestine on social media and in your professional organizations 

What you can do as a repro-activist:

• issue a statement of solidarity with Palestine

• take part in local and national solidarity and peace protests

• organize transnationally to facilitate and support reproductive justice in Palestine

• incorporate and connect Palestine to the struggles you are involved in

• don’t stop talking about Palestine

Notes 

[1]  Al Nakba, meaning ‘the catastrophe’ in Arabic, refers to the violent displacement and dispossession of Palestinians, and the destruction of their society, culture, political rights, and national aspirations. For more, see: The United Nations, Jewish Voices for Peace, Al Jazeera, and Haaretz.

[2]  See for instance Yuval Davis, 1989; Kanaaneh, 2002, Weiss, 2002; Nahman, 2013, Hasso, 2022, Vertommen, 2016.

[3] In 1949, for example, Israel’s first Prime Minister David Ben Gurion issued the Heroine Mother Award, a birth prize for Israeli mothers at the birth of their tenth child. The award was dropped after ten years, when it turned out that mostly Palestinian mothers were claiming the financial reward. In 2010, the Israeli Knesset voted in favour of a controversial law to allow egg cell donations. One of the amendments in the Law on Egg Donation stipulated that the donor and the recipient of the egg cell are required to share the same religion which makes it impossible for a Jewish woman to donate an egg cell to a Muslim, Christian or Druze couple and vice versa without the approval of an Exception Committee. Since in practice, Palestinian women rarely donate egg cells in Israel, this amendment ensured that they will also be unlikely to benefit from an egg cell donation.

[4] See for instance, Shalhoub-Kevorkian, 2015;  Abdo, 2011;  Nahman, 2013; ; Vertommen, 2015.

[5] There are hopeful exceptions, such as statements by BRISMES, MESA, BSA, ICCG, ESA, Department of Conflict and Development, etc.