Pregnant in a war zone: What are your choices?

In Yemen women give birth in caves to avoid air strikes, in war-torn Syria child marriages are increasing, while in eastern Ukraine, where conflict has been raging for two years, domestic violence is rising, aid agencies have been reporting.

Even though these scenarios are typical of the hardships faced by women in conflict zones or disasters, too little is being done to address their needs beyond providing them with the most basic humanitarian aid, said Babatunde Osotimehin, executive director of the United Nations Population Fund (UNFPA).

"The focus is on water, food and shelter and that's crucial and life-saving but life does go on in conflicts and disasters, including sex and births," Osotimehin told the Thomson Reuters Foundation in an interview in London.

Numerous studies have shown women in need of aid because of conflict or disaster are more vulnerable to sexual violence, sexually transmitted diseases and unwanted pregnancies, he said.

An UNFPA report last December said more than 500 women a day die from complications arising from pregnancy and child birth in countries facing conflict or disaster.

"Even in peaceful times, it can be difficult to become a mother. But in a war zone, on a boat with smugglers, or in a refugee camp, being pregnant is truly daunting," Osotimehin, a physician and former Nigerian minister of health, said.

As humanitarian crises have multiplied in recent years and more than 100 million people now being in need of assistance, women's health and reproductive rights are often an afterthought, he said.

URGENT NEED

UNFPA said in February it is seeking $107 million to meet the needs of women and girls affected by the war in Syria, the world's largest humanitarian crisis.

Four million people out of around 13.5 million in need of humanitarian assistance inside Syria are women and girls of childbearing age, U.N. data shows.

Among those who have taken refuge in neighbouring countries, 1.2 million are of childbearing age.

Osotimehin said child marriage is now being used by desperate parents in Syria, who fear for the safety of their daughters and marry them off in the hope that they will be protected and provided with food and other necessities.

In other war-torn countries the needs of women and girls are equally pressing.

In Yemen, where war has been raging for more than a year, Medecins Sans Frontiers said in February that pregnant women had been seeking shelter in caves to give birth rather than risk going to a hospital.

Osotimehin urged world leaders and aid agencies gathering for the first humanitarian summit in Istanbul, Turkey, later this month to make women's and girls needs a key part of the humanitarian response as standard.

"It is crucial to direct humanitarian aid to protect women of childbearing age, both to lessen present suffering and reduce it in the future, but current resources are insufficient," he said.

TALK BUT LITTLE ACTION

Global leaders launched a new women, peace and security programme last March, including workshops, training and guidelines to ensure that gender equality and the needs of women and girls are an integral part of the humanitarian response.

While there has been no lack of talk about the needs of women in conflict zones, too little is being done to translate words into concrete and coordinated action, said Osotimehin.

The U.N. adopted a resolution on women, peace and security in 2000 and a call to action saw donors and international agencies commit in 2013 to reducing violence against women in emergencies, while a London summit in 2014 agreed steps to tackle impunity for the use of rape as weapon of war.

Despite those efforts it is unclear how much money is being invested on these issues because there is no uniform way of reporting funding and what it is spent on, said Osotimehin.