When birth meets war: A focused ethnography of midwives' experiences in a hospital birth unit during wartime in Northern Israel

Armed conflict poses unique challenges to maternity care, reshaping both the physical infrastructure and emotional labor of birth.

This study examines how midwives in a northern Israeli hospital navigated birth work during sustained rocket threats in 2023-2024.

This focused ethnography draws on interviews with five hospital midwives and twelve women from the same region, conducted during the war. Using interpretative phenomenological principles, the analysis highlights the embodied, emotional, and ethical dimensions of midwifery under duress.

Three central themes emerged: 1. Midwifery in Displaced Space - Navigating Work and Meaning in a Temporary Birth Unit: Midwives described spatial and emotional dislocation resulting from working in an improvised setting, which challenged their capacity to maintain intimacy, privacy, and professional presence. 2. Crisis Work and Ethical Commitment - Practicing Midwifery under Threat: Despite fear and exhaustion, midwives expressed a strong ethical commitment to providing care and viewed birth work as meaningful resistance during wartime. 3. Ideal vs. Real - Intimacy, Intervention, and the Midwife-Woman Bond: Fewer births allowed more individualized care, yet also led to heightened surveillance and increased interventions. Diverging midwifery philosophies emerged, particularly regarding women's autonomy and institutional constraints.

Midwifery during wartime revealed both vulnerability and resilience. While the crisis disrupted standard routines, it also opened possibilities for woman-centered, relational care - alongside new pressures of accountability, ambivalence, and institutional constraint. The study contributes to the anthropology of birth in crisis zones and highlights the ethical complexity of providing care in contexts of both threat and trust.