Conflict in Yemen: Devastating toll on pregnant women and new mums becomes clear as malnutrition admissions soar

The number of pregnant and breastfeeding women treated for acute malnutrition almost doubled between 2016 and 2018, new data from Yemen has shown.

Despite the rapid scale up, it is estimated that in 2018 more than 150,000 went untreated due to brutal fighting, lack of access to critical areas and underfunding.

Malnutrition puts the lives of both mothers and babies at risk. These figures reveal a hidden and heartbreaking cost of more than four years of war, Save the Children is warning. Aid agencies on the ground have scaled up massively in the face of huge need of the pregnant women and new mothers, but to push back this tide of malnutrition the bombs and bullets must stop now, Save the Children added.

In 2016 nearly 220,000 pregnant and breastfeeding women were admitted to health facilities in Yemen with acute malnutrition. As the response expanded, the figure surged to nearly 410,000 during 2018 - an increase of 87%.

Malnourished pregnant women run an increased risk of miscarriages and the anguish they cause, along with anemia and even dying during childbirth.

Their babies may be born prematurely and, if they survive, suffer from a low birth weight and stunted growth. Stunting can have a lasting effect on the child’s development, both physically and mentally. Babies born to malnourished mothers can be more susceptible to infections.

Dr Mariam Aldogani, Save the Children’s Field Manager in Hodeidah, said:
“This is a creeping but catastrophic consequence of the brutal conflict. We regularly see hungry pregnant women surviving on just one meal of bread and tea a day. Many come to our clinics unable to walk, too exhausted from not getting enough to eat.

“Maternal malnutrition is a deadly threat to both mother and baby. And it can cause lifelong problems for babies who survive, hitting their development and education long after the fighting is over.”

Yusra*, 21, lives in Hajjah governorate together with her husband, who hasn’t been able to find regular work since the conflict escalated. They survive on just over $1.50 (US) a day. She said:
“I miscarried three times. I have visited more than one hospital and the only answer I get is that my body is too weak to carry a child.”

“After I lost my last baby 11 months ago, I visited a health center near to my house. The doctor gave me some medicines and vitamins. Now I feel that I am getting better. I hope Yemen returns to how it was before or even better than before and our country becomes safe. And I wish I could have a child.”

Malnutrition is one factor that can lead a mother to miscarriage, along with others such as infections, extreme fear, environmental circumstances and a lack of vitamins.

Dr Hayat, who treated Yusra and other malnourished pregnant women:
“The pregnancy progresses normally but due to malnutrition when she reaches a certain month, she miscarries. Suddenly they call me that she has pain and I go to her. She would have heavy bleeding and we take her in an ambulance to the city. There would be nothing that I could do for her.

“We get many cases of miscarriages in the centre that are due to  malnutrition, we also have pre-term births.”

Conflict has brought the country to the brink of famine by causing food shortages and high prices. Fighting and other obstacles have repeatedly blocked vital aid and commercial food supplies from getting to communities that need them most.

Despite the first steps towards a peace process being taken in Stockholm in December, fierce fighting continues in many areas. More than 420,000 people have forced from their homes in the last six months alone.

Save the Children calls on the international community to continue pressing all warring parties to allow full humanitarian access. It has delivered just a fraction of the funding pledged to Yemen, and steps need to be taken to help those on the ground save lives. But the aid agency says that for the suffering to end, so must the war. The international community must do everything in its power to build on the fragile progress made at Stockholm and bring the conflict to an end.

Around 2.5 million pregnant or breastfeeding women in Yemen are in urgent need of nutrition and counselling services to treat or prevent malnutrition.

Save the Children has centers all over Yemen to screen children, pregnant women and new mothers for malnutrition. The most severe cases are treated in stabilisation centres. Since the war escalated, the aid agency has helped treat over 58,000 pregnant and breastfeeding women, and more than 170,000 children under five, for malnutrition. Save the Children is also ensuring children have enough to eat by distributing food and nutritious supplements to babies, pregnant women and mothers with newborns.

*Name changed to protect identity.

Notes to editors:
- All figures on acute malnutrition admissions among pregnant and breastfeeding women based on analysis of Yemen Nutrition Cluster data.
- Increase of the number of admissions for maternal malnutrition has accelerated since 2016. It grew by 14% from 2016 to 2017, and by 64% the following year.
- From 2017 to 2018 the number of pregnant and breastfeeding women admitted for malnutrition rose in 17 out of 22 governorates, but in some areas the numbers spiked particularly sharply. In Al Jawf maternal malnutrition admissions were fourteen times higher in 2018 than 2017. In Hadramaut and Dhamar they were nearly eight and six times higher, respectively.

- In Taiz, the number of admissions rose by nearly 40,000 in 2018 compared to the previous year. In Ibb the figure rose by around 21,500 and in Amran by around 18,500.
- Aid agencies and commercial food importers face huge barriers to access in Yemen. Despite a ceasefire in Hodeidah largely holding, commercial food imports through this key port in the first quarter of 2019 were about 40 per cent lower than the previous quarter. Average food prices were more than twice the pre-crisis level.
- Save the Children has previously estimated 85,000 children under the age of five may have died from extreme hunger and disease since the conflict escalated on March 26, 2015.

- So far in 2019 there have been 100,000 suspected cases of cholera among children in Yemen.

- In February donors pledged $2.62 billion to the 2019 humanitarian response in Yemen but four months into the year only about 10 per cent of what was pledged has materialised. The amount is 80 per cent less than this time last year. Funding progress can be followed on the humanitarian financial tracking service.
- In 2018 aid agencies treating malnutrition in Yemen aimed to treat nearly 565,000 acutely malnourished pregnant and lactating women. Altogether they reached nearly 410,000.