Jabalia, Gaza Strip – In Jabalia, the joy of welcoming a newborn is tempered, to say the least.

Marred by the pain of displacement, by mothers having to give birth while fighter jets fly overhead, and by the uncertainty of what future these babies will have.

Al Jazeera spoke to three women seeking refuge at a United Nations school in Jabalia, northern Gaza, about their pregnancies and births, the losses they have suffered and whether they can feel joy at the birth of their babies .

Aya

Aya Deeb sits in the corner of a room in a school run by the UN Relief and Works Agency for Palestine Refugees (UNRWA). She speaks quietly as her baby Yara sleeps next to her. The environment around her is clean and tidy, and Yara is well cared for, lovingly covered with a pink blanket in the converted car seat in which she sleeps.

As she adjusts her blue patterned Isdal robe, Aya tells Al Jazeera how she was afraid of losing Yara before she was born on Christmas Day.

Weeks before the birth, Aya – long displaced from her home in Bir an-Naaja in the northern Gaza Strip – had moved from one precarious shelter to another to escape Israeli bombs.

“In the early days of the conflict, we had moved to my husband’s uncle’s house in Zawayda for security reasons. But then they targeted the house next door and my husband died in that attack,” she says.

The pregnant woman then took her little son Mohamed with her. She returned north to stay with her family, moving from one place to another until she and her parents ended up in school along with thousands of other displaced people.

“I was so depressed in the last few months of my pregnancy. There are so many things a pregnant woman needs in her last trimester, but there wasn’t even enough food or clean water,” she says with an exhausted face, suppressing her emotions.

“But the worst part was my sadness over my husband and the fact that I didn’t have him with me during the birth.”

Aya’s contractions began on Christmas Eve and increased throughout the night until her parents took her to the shelter’s clinic at 2 a.m. and ran everywhere to find a midwife who could help her give birth.

Shortly thereafter, at about 5 a.m., Aya estimates, Yara arrived – born on the clinic floor behind a sheet stretched over a corner of the room, the only privacy the clinic staff could provide.

“I was having contractions and all I could hear was the roar of the fighter jets overhead and the shelling. There was fear everywhere,” says Aya.

Yara has not received a birth certificate and has not received any vaccinations. Her mother also had no medical care.

When asked what she wishes for her daughter, Aya replies: “A long life, in peace without war. You see so much at a young age.”

Aya is one of thousands of women in Gaza forced to deliver and care for their newborns under Israel’s war in retaliation for Hamas’ October 7 attacks.

The war has devastated Gaza’s health system, while 180 babies are being born every day, according to the UN. From October 7 to January 5, the World Health Organization documented 304 Israeli attacks on health facilities in Gaza, which also killed more than 300 medical personnel.

The severe shortage of doctors and midwives and the Israeli siege of the Gaza Strip are threatening the lives of countless pregnant women and babies.

Trainer

Raeda al-Masry also wears an Isdal ubiquitous garment worn by women in Gaza to protect your privacy.

Sitting cross-legged on the floor of a classroom where she has taken shelter, she holds her baby in the burping position and lightly pats his bottom as she speaks animatedly to Al Jazeera.

Raeda comes from Beit Hanoon and was expelled to Jabalia in the first days of the war.

“The block where we were sheltering was bombed and the rescuers, myself and my older son, who is 14 months old, pulled me out from under the rubble,” she explains of how they got to school.

“Moath was born here in the classroom about two months ago. When I went into labor we called an ambulance or something, but there were no resources. Nobody came to help.

“Oh my God, it was such a difficult birth. There is nothing here that could help during a delivery. I didn’t even have clothes. People had to shop around to find something I could put Moath in.”

While Raeda managed to get to Kamal Adwan Hospital after Moath was born to have them both checked, there were no vaccines. He remains unvaccinated.

“They told me there were no vaccines, … but look where we are. The baby is here at school, where all kinds of diseases are spreading. Something is happening to his chest at the moment. He’s having a hard time breathing, but there’s nothing I can do.

“I don’t eat enough to breastfeed him either. Some people helped me by bringing me a formula.

“My wish for my son is that he lives, that he has security, that he has food and even diapers. I don’t want him to grow up in need.”

A bike

Um Raed also sits holding her little boy, wrapped in a fluffy blanket and sleeping soundly, perhaps comforted by the sound of his mother’s voice and her rocking motions as she holds him.

He has often been sick since he was born, says Um Raed with big, serious eyes and the frustration of not being able to do more for her child on her face.

“Here in the school hostel I completed my full time at school,” she says, “but I didn’t go into labor, probably because of the fear I was living in.

“So from here I walked to Kamal Adwan Hospital every day to get checked. I did that for three days – I couldn’t understand why my contractions weren’t starting.”

Like thousands of other mothers in Gaza, when she went into labor, she had to give birth in rudimentary, unsanitary conditions and without safety precautions, simply because Gaza’s health system was no longer able to offer anything.

“Since I was born, I didn’t know whether to focus on my contractions or the sound of the fighter jets overhead. Should I be worried about my baby or should I be afraid of the seizures that are happening?

“You know, for such a small baby, he has learned to recognize the sounds of bombings. Whenever there are bomb attacks here, he is frightened and afraid. I don’t think babies that young should be able to recognize danger in this way.”

On October 9, Israel tightened its siege on Gaza, denying food, water and medicine to its population, including a million children, about a third of whom are under five years old.

Newborns are most at risk because their mothers often don’t get enough calories to breastfeed them and there is a lack of baby formula.

When asked what she wants for her little boy, Um Raed answers “vaccinations”.

Longer term, she says, she wants what every mother wants for her child: that Raed grows up in a healthy environment, in peace and not suffering hardship and not learning about war at such a young age.

However, the three mothers agree: this is the reality of the war, into which thousands of babies are being born, and there is no end in sight.

As much as they want the best for their babies, they are also afraid of what might happen to them if Israel continues its attack on Gaza.