“I told my husband I would not survive childbirth again, because I have diabetes,” says Negah Abdallah Ali, who just delivered her healthy baby, Ashraf, at the Doctors Without Borders/Médecins Sans Frontières (MSF) maternity ward at the Mocha general hospital.

Here on Yemen’s west coast, it’s a sunny Monday afternoon. Outside, the air is a heavy 35 C, but inside the post-delivery room, Negah and the other mothers can feel a soothing breeze from the air-conditioning.

On top of having diabetes, Negah has hypertension. Both conditions increase the risks associated with pregnancy and delivery. Negah is one of the thousands of women who come to this MSF maternity ward during their pregnancy. As in most countries affected by conflict, Yemen has a collapsed healthcare system, leaving women’s and children’s health particularly vulnerable.

“We are the only 24/7 maternity and pediatric wards in the entire west coast area, which covers a little more than half a million people,” says Ann Van Haver, MSF midwife activity manager.

In July 2024, MSF integrated our maternity services into Mocha general hospital, allowing us to expand our services, including opening a new comprehensive obstetric and neonatal care ward. Today, the maternity ward has 28 beds for delivery and post-delivery, including beds for neonatal and intensive care.

Yemen’s west coast is a rural area with frontlines to the north and east. Women with high-risk or complicated pregnancies sometimes make a three-hour drive to reach Mocha. An expected 15 per cent of the deliveries have obstetrical complications, which, if not treated in a timely manner, can be fatal.

The risks and complications faced by women in the area are easily preventable, but without consistent and accessible prenatal and postnatal care, pregnancy becomes more dangerous.

“There are so many challenges for mothers in Yemen, and most of them are linked to the war, making access to the few health centres left too complicated,” says Altaf Al Wahidi, a midwife at the MSF maternity. “That’s why the location of this maternity is so crucial. We cover a large area of the west coast.”

The complications that women experience can be dealt with by the hospital and its staff, if patients arrive on time. However, Van Haver insists a closer-to-home first line of care should be available. Considering the west coast population, around 1,300 women are expected to give birth each month.

“Around 250 are delivering [monthly] with us now,” says Van Haver. “So, there are a thousand other deliveries every month somewhere else. And today, this is not

There are many factors working against a woman’s ability to reach a hospital on the west coast: conflict, checkpoints along the roads, dire economic conditions and the need to get formal consent from a male family member for any medical act, including a caesarean section.in health facilities. And because of that, we see a lot more complications requiring invasive treatments.”

Fatema* is 16 years old. She went to the hospital as soon as she thought her labour started, but it wasn’t progressing. She returned home a few hours later, only to then suddenly deliver at home with the help of her mother.

“The delivery went well and the baby is fine but I experienced some bleeding afterward,” says Fatema. “In the morning, I returned to the hospital, where I received proper medical care to stop the bleeding. I am happy and relieved that the pain is gone and that I will be discharged soon to see my baby.”

Back in the post-delivery room, Negah is visited by the health educator, Bashira Seqek, who gives her information about paracetamol toxicity, the benefits of breastfeeding and family planning. Meanwhile, in the corridor, her husband Ali Abdallah Ali holds their one-day-old son.

“Since the maternity opened here in Mocha, everything is available, and I am grateful for that,” says Ali. “I feel 100 per cent confident about the services provided. In my village, we all know we have to come here for matters related to maternal care.”

Behind the door, where non-medical male staff aren’t allowed, the maternity ward is a woman’s world of dignity and solidarity that pulses to the rhythm of the midwives.

*Name of patient changed to protect identity.