Childbirth in an underground maternity ward during wartime: maternal birth experience and early bonding

Armed conflict may adversely affect childbirth and maternal well-being. Following the October 7, 2023 attacks and subsequent missile threats in northern Israel, maternity services at our tertiary medical center were relocated to a fortified underground facility. We evaluated childbirth experience, labor-support preferences, and maternal-newborn bonding during wartime.

This prospective questionnaire-based study was conducted between October 2023 and February 2024 at a tertiary medical center in northern Israel. Participants completed anonymous questionnaires before childbirthand within 48 h postpartum. The survey assessed preferred labor support, the perceived impact of the war on childbirth and postpartum hospitalization, and maternal-newborn bonding. Findings were compared with data from a similar pre-war questionnaire study conducted between 2017 and 2018.

A total of 200 women participated. During the study period, hospital delivery volume declined by 25% compared with the corresponding period in the previous year. Overall, 49% of participants reported that the war negatively affected their childbirth experience, 80% reported an adverse effect on their postpartum hospitalization experience, and 30% reported that the war negatively affected bonding with their newborn. 11% reported that the war influenced their choice of labor supporter, and 22% had a family member on active military duty. Compared with the pre-war cohort, more women preferred the presence of a support person during instrumental birth(P = 0.001).

Women giving birth during the war in an underground maternity ward frequently reported adverse childbirth and postpartum experiences, including perceived negative effects on newborn bonding.