Deaths from violent conflict and lack of available care are major causes of mortality among pregnant women in war zones and so more needs to be done to protect women from violence in conflicts and to provide appropriate medical care required, argue doctors in an editorial published in The BMJ today.

Though no one has any idea how many pregnant women die in conflict every year, they argue that humanitarian law should protect them anyway. But how? The United Nations never solves conflicts, it can only pass resolutions. Laws don't protect the 140,000 women who die in conflict each year. Over 300,000 women already will die in pregnancy and childbirth.

The authors contend violence is directed specifically against pregnant women, for example, through torture and rape, in regions such as the Mid-East and Africa. "Those lucky to survive are at risk of post-traumatic stress disorder, which negatively affects maternal functioning, parenting, and compliance with medical therapies," they argue.

Furthermore, health services can be destroyed in wars, as seen in the recent massacre of 11 Médecins Sans Frontières health workers in Syria, and the accidental bombing of Kunduz trauma hospital in Afghanistan.

"The cumulative effects of these problems can be devastating for women in war zones--and in turn take their toll on their children, families, and communities," they warn. "All too often the only option is for women to attempt the dangerous escape from the war zone and seek refuge in other countries."

They suggest a number of solutions, but also argue for political magical thinking - "the final answer must lie in political settlements to resolve the root cause of the conflict. Warring parties should be educated about international humanitarian law to tackle the underlying ignorance."

Other recommendations are more practical. "A functioning operation theatre is also vital," they say. Of over 18,000 operations carried out 'in the field' by MSF Brussels in 2014, 21% were caesarean sections and 6% other gynaecological or obstetrical procedures. 

Source: BMJ