Examining the link between chemical attacks and birth defects in Syria

At least 200,000 pregnant women are in need of access to health care in Syria

Brooklyn Middleton

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There was baby girl Fatima - severely deformed - who reportedly lived less than 10 hours after she was born and then there is baby girl Joud - whose tiny limbs lead to only one foot, a missing fingertip and toe. With increasing frequency, Syrian activists and medical professionals have indicated an uptick in birth defects among newborns whose pregnant mothers were affected by the deadly sarin gas attack in East Ghouta during the morning hours on August 21, 2013 which killed at least 366 people and injured thousands more.

Like most reports emanating from Syria, the evidence is recorded by the brave ones who remain within Syria’s borders and then redistributed by those on the outside.

Sans any official investigation, there is no definitive evidence that pregnant women inhaling sarin caused them to deliver babies with birth defects nine months later but according to Professor Christine Gosden, from the UK-based Institute of Translational Medicine, while military research exploring a potential link between sarin gas and birth defects remains limited, her own department’s research indicates a link.

Birth defects on the rise

Even prior to the chemical weapon attack, birth defects among Syrian newborns were reportedly on the rise. In December 2013, Dr. Joanne Liu, International President of Medecins Sans Frontieres, wrote a blog post indicating she herself saw what she referred to as an “unusually high number” of children with birth defects when she was present at a field hospital in Aleppo. While noting it was impossible to confirm at the time, she did indicate the birth defects could have resulted from pregnant mothers’ lack of access to folic acid.

At least 200,000 pregnant women are in need of access to health care with approximately 1,480 women giving birth on a daily basis in “dire conditions”

Brooklyn Middleton

With that noted, the increasing number of reports detailing birth defects serve as a reminder that Syria’s ongoing conflict continues having dire consequences on maternal and reproductive health care.

According to a recent press release by the United Nations Population Fund, at least 200,000 pregnant women are in need of access to health care with approximately 1,480 women giving birth on a daily basis in “dire conditions.” Meanwhile, the rate of cesarean sections has skyrocketed from 19 percent in 2011 to approximately 45 percent two years later. A recent Save The Children report indicated an even higher cesarean section rate at a hospital located in a besieged area: a staggering 75 percent.

In both reports, no figure indicated the percentage of women who received comprehensive post-cesarean section follow-up care.

Postpartum and postnatal care

Further, access to any postpartum and postnatal care has dwindled to non-existent in some areas and less than 50 percent of remaining public health facilities remain fully equipped to care for newborns. With hospitals continuing to be attacked with crude regime barrel bombs - like on April 21 in Hanano and April 13 in al-Shaar - the number of health facilities is only likely to lessen while the need for them only increases.

A lack of access to maternal health care as a byproduct of an ongoing conflict is not unique to Syria but the intentional targeting of pregnant women by military snipers may be; in October 2013 British surgeon David Nott accused military snipers of “absolutely deliberately” targeting full-term pregnant Syrian women with a shot to the abdomen that usually killed the fetus and sometimes the mother. He added that to care for these injured, would-be mothers was “for a doctor, one of the most distressing things you could ever, ever possibly do.”

The Assad regime has consistently proved capable of facilitating the transfer of humanitarian aid to areas of need when it sees it as politically beneficial to do so; this was clearly demonstrated - though only briefly - during the Geneva II talks when food slowly made its way to the literally starving to death Yarmouk refugee camp. While it is impossible to hope that Assad will ever prioritize health care for pregnant women - when his helicopters continue to drop barrel bombs on health facilities that would serve them and his snipers have intentionally targeted unborn fetuses - the international community must demand maternal health care remains a top priority.


Brooklyn Middleton is an American Political and Security Risk Analyst reporting from Israel. Her work has appeared in Turkish and Israeli publications including The Times of Israel and Hürriyet Daily News. She has previously written about U.S. President Obama's policy in Syria as well as the emerging geopolitical threats Israel faces as it pursues its energy interests in the Eastern Mediterranean. She is currently researching Ayatollah Khomeini’s influence on Hamas and the Palestinian Islamic Jihad militant groups to complete her MA in Middle Eastern Studies. You can follow her on Twitter here: @BklynMiddleton.

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