In a conflict zone, getting the basics — food, water, shelter — is a constant challenge. And it likely involves being on the move.
Now imagine pregnancy. There might not be a functioning medical facility for miles. And your environment makes you and your baby more susceptible to complications.
Aid groups are increasingly relying on conflict midwives to help women in these situations. Take Emily Slocum, a midwife with Doctors Without Borders, who worked with women affected by the violent conflict in the Democratic Republic of Congo. Some traveled days to reach her.
The Congo war lasted from 1998 to 2004, but as NPR's John Burnett has reported, ongoing conflict continues to disrupt daily life. The country has millions of displaced people.
Slocum worked at a hospital in South Kivu, where the conflict still lingers, from November 2011 to May 2012. She tells Shots that one of the challenges was keeping underweight newborns warm. Without an incubator, the best practice is to have the mother hold the baby to her skin, to keep its body temperature up, she says. She had to teach nurses and mothers to do that when she arrived.
"The baby was immediately sort of taken away and assessed by the nurse and sometimes not given back to the mom immediately," she says. In Syria, an MSF midwife encountered a similar problem, and to improvise, she heated IV fluid bags in the microwave to make small hot water bottles to warm the newborns.
Breastfeeding is also critical in situations where potable water and food access is limited and general hygiene is poor, the Inter-agency Working Group on Reproductive Health says.
Crises also put people at higher risk for sexual violence. In the Congo, women had very limited access to health care at all – nevermind contraceptives, Slocum says. But even for a population that's constantly fleeing violence, Slocum could provide long-term solutions with particular birth control methods, such as implants that can last up to five years.