A refugee and mother of seven children, Madina Mohamed was forced to flee her home in southwestern Somalia after her husband was killed amid escalating regional conflict. She only managed to bring three of her children with her. To this day, she doesn’t know where two of her children are.
Around the world, hundreds of thousands of women like Madina are facing traumatic circumstances and impossible choices. The global community tends to focus on the ways children are impacted in fragile settings, yet women face distinct challenges — especially when they are pregnant, breastfeeding or caring for young children.
Pregnancy and Malnutrition: A Dangerous Combination
Too often, life gets harder for women when they are pregnant. They still bear the burden of fetching water and firewood, sometimes walking long distances each day. In both rural and urban settings, their families may rely on food or income from a “kitchen garden,” which women typically tend, or the work they do outside of the home. If pregnancy makes those activities harder, the expectant mother and her family may have less to eat.
That’s particularly challenging when women are already food insecure — as one billion women and adolescent girls are today. And, as one displaced mother in Gaza said, “I prefer to give the children food first, and then, as a mother, I might not eat so that I can feed my children. That’s just how life is; that’s motherhood.” Yet, malnutrition and pregnancy are a dangerous combination.
Malnutrition weakens a woman’s immune system and overall health, with pronounced risks during pregnancy. Diets lacking essential nutrients increase the likelihood of pre-eclampsia, a serious condition involving high blood pressure and potential organ damage during pregnancy. A lack of iron can lead to anemia, which increases the risk of hemorrhage during childbirth. Malnutrition also leaves pregnant and breastfeeding women more vulnerable to infectious diseases such as cholera.
An intestinal disease transmitted through dirty water, cholera can be transmitted to women and adolescent girls as they engage in traditional housekeeping tasks, such as collecting water, cooking food, cleaning latrines, and caring for sick family members. For example, in Yemen, cholera is creating an additional risk for the 1.3 million pregnant and breastfeeding women who suffer from malnutrition.
While fairly straightforward to treat, cholera can kill within hours without medical attention — which isn’t available in many parts of the world. It spreads so rapidly that even one case is considered an epidemic. Most cholera-affected countries fall above the global median in terms of gender inequality, where female malnutrition is likely to be higher.
From increasing resistance to disease to lessening the toll pregnancy takes on a woman’s body, good nutrition is essential while pregnant. So it’s concerning that maternal acute malnutrition rose 25% between 2020 and 2022 in the 12 countries most affected by food insecurity. These countries alone account for almost 7 million acutely malnourished mothers.
The risks rise if mothers are extremely young or when pregnancies aren’t optimally spaced for maternal health. And the issues extend beyond pregnancy itself.
Breastfeeding Women Also At Risk
Breastfeeding provides important nutritional and development benefits for children. In fact, the World Health Organization recommends exclusive breastfeeding for the child’s first six months. Additionally, breastfeeding saves families money they might spend on formula and eliminates the risk of exposing infants to contaminated water, making it a safer, more economical choice. Research also indicates that breastfeeding can benefit women by supporting maternal and mental health, preventing diabetes, heart disease, and certain forms of cancer.
For all its benefits, breastfeeding places high nutritional demands on the mother’s body. Malnourished women may become depleted in essential nutrients like iron, calcium, and vitamin D, compromising their health and immune function.
“Few women are made aware of the importance of nutrition when they are pregnant or breastfeeding. Yet they are particularly exposed to the risk of anemia or vitamin D deficiency,” explained Dania Al-Qaisi, doctor and nutrition trainer for Action Against Hunger in Iraq. In some communities, nearly one-third of lactating mothers suffer from undernutrition. That’s not inevitable.
How Can We Best Support Mothers?
We know what works in promoting nutrition and health for women before, during and after pregnancy. Here are five examples:
Improve Family Planning and Maternity Care: One of the biggest ways to minimize health risks for women is to provide family planning and invest in maternity care. For example, in some countries, Action Against Hunger staff provide evidence-based training to health workers around maternal health. Participants learn crucial skills, such as how to monitor pregnancy and address prenatal complications, diagnose health and nutritional concerns, and support breastfeeding women.Bolster Nutrition: Good nutrition is a building block for everything else, and we work to make gender a priority across all of our programs. Since it can be even harder to ensure good nutrition in emergency settings, we focus on the needs of women in places like Gaza. There, with support from the World Food Program (WFP), Action Against Hunger is distributing nutrient supplements to pregnant and breastfeeding mothers.Advance Education on Health and Nutrition: Many communities don’t have ready access to essential information on nutrition, pregnancy and breastfeeding. Educational programs are effective, and in places where traditional gender dynamics mean women eat last and least, it’s also important to engage men in the conversation. In communities around the world, Action Against Hunger provides educational sessions for mothers and caregivers, covering a wide range of topics, from nutrient rich foods and dietary diversity to the benefits of breastfeeding.Organize Support Groups: Women refugees often face significant trauma, including physical violence, sexual assault, and death of loved ones, which can take a significant toll on mental health. Mothers facing psychological distress may struggle with feeding themselves and their children, making mental health care crucial for pregnant and breastfeeding women. Action Against Hunger organizes support groups for pregnant and nursing mothers in refugee camps to provide women with a safe space to discuss hard topics.Build resilience: The risks for maternal mortality and sexual and gender-based violence increase during conflicts, natural disasters, and other crises. PROPEL Adapt, a program funded by USAID and implemented by Action Against Hunger, takes a cross-sectoral approach to building resilience. Policy, financing, government accountability, resources and training, and evidence-based advocacy and strengthen health systems to benefit women, families, and communities as a whole.
These programs work. After meeting the team at Action Against Hunger’s Maternal and Child Health Center in Hudur, Madina has become a champion against hunger. One of 1,500 mothers in the area trained by Action Against Hunger, she participates in mother-to-mother support groups, helping others to overcome some of the obstacles she has faced.
“The support group has been a key activity for me at the center, and it has played a major role in my healing process,” Madina said. “After experiencing conflict and living in a displacement camp for a year, sharing my story with other mothers in the group has been a great part of my journey. When I get the chance to go back to my village, I will make it my business to deal with cases of malnutrition and to educate women on the importance of good health and hygiene.”
Mother’s Day, May 12th, can be a reminder of the health risks faced by pregnant and breastfeeding women around the world — and an opportunity to support them. By investing in maternal health care, support networks, and nutrition education, we can make sure that every mother — and child — has the opportunity to thrive.
About Action Against Hunger
Action Against Hunger leads the global movement to end hunger. We innovate solutions, advocate for change, and reach 28 million people every year with proven hunger prevention and treatment programs. As a nonprofit that works across 55 countries, our 8,900 dedicated staff members partner with communities to address the root causes of hunger, including climate change, conflict, inequity, and emergencies. We strive to create a world free from hunger, for everyone, for good.
