Amid the deadly war in Gaza, a new life begins. But newborn babies and babies still in the uterus have been hit by one of the worst hits by harsh conditions.

The United Nations said that one in 10 newborn babies are underweight or premature due to a sharp shortage of food. Miscarriage, stillbirth and congenital abnormalities also increased.

At the Nasser Hospital in the southern city of Khan Younis, Malak Brees, now seven months pregnant, is worried about Israeli bomb attacks and evacuation orders and lost her baby.

“I’m afraid I can give birth at any time and my amniotic fluid is not enough for the baby to grow,” she told the BBC.

Marak didn't expect to get pregnant with her second child. Six weeks ago, she lost a lot of amniotic fluid, putting the baby in danger.

“The doctors told me it was due to malnutrition and fatigue… they told me that it was in the hands of God – the fetus can survive or die.”

Although malnutrition poses new harm in pregnancy, delivery has also become more risky.

On March 2, Israel's total lockdown on Gaza - saying it was pressure on Hamas - was partially relieved only two weeks ago. There is a lack of basic medical supplies, including painkillers and basic hygiene products.

Sometimes, Israeli military operations and displacement mean that women are born in tents or shelters without medical help.

"If mothers are lucky enough to come to the hospital to give birth, those vaginally women are usually sent home three to four hours later," said Sandra Killen, a registered emergency and pediatric nurse in the United States.

"The woman with surgical caesarean section (Casale) was discharged 24 hours later," she said.

“They are often discharged with babies with conditions and various problems that we will stay in the hospital for more support under normal circumstances.

"Most babies outside Gaza, born at 1,400 grams (3.1 pounds) below 32 weeks, will be in the NICU (Neonatal ICU). These babies are sent home. They have no space."

Nasser Hospital still has a newly-produced ICU and is already full. Doctors say they were overwhelmed by patients since the nearby European hospitals' deadly Israeli bombing on May 13.

Israeli troops attacked the hospital several times in the nearly 20 months of the war and said it targeted local Hamas leader Mohammed Sinwar, an underground base below the European hospital compound.

It accuses Hamas of typically hiding its combatants and infrastructure behind patients and injuries, which armed groups deny.

With the very difficult access to basic health care now, the majority of the UN estimates are 55,000 pregnant women in Gaza, unable to undergo regular prenatal checkups.

"The state of mind of women during childbirth is heartbreaking, and God helps them," said Dr. Ahmad al-Farra, head of pediatrics and maternal care at Nasser Hospital.

"They are fully aware that unborn babies are not properly monitored and that they themselves are not getting adequate nutrition, so they expect babies to have low birth weight or other complications. That's the first problem."

"The second is that after delivery, they are very worried about how to manage breastfeeding or even a safe formula, especially in the case of persistent lack of food. Both options are equally difficult."

Wiping away tears, Aya al-Skafi is watching a picture of her daughter Jenan in a shelter in Gaza.

The baby was born during the ceasefire earlier this year and initially she was in good health. But as food became scarce, her mother struggled to breastfeed.

"After the crossing is closed, everything shuts down us," Aiya said. "No flour, no clean water, no food as healthy as fruits and vegetables. When my condition worsens, Zhan Nan's condition will worsen."

Zhan Nan was diagnosed with malnutrition and dehydration and had problems with digestion. The doctor couldn't find the special formula she needed.

"I want to scream to the whole world and say, 'Save my daughter from death, save her!''

"I beg for help, but only God, the Lord of the World answered. Only God saved her from the cruelty of this world."

Jenan died last month - she was four months old.

Many mothers are working to breastfeed due to their poor health, but a Scotland-based organization, Gaza Infant Nutrition Alliance, has been training local medical staff to provide more support.

Nurse Sandra Killen, who is also a lactation expert, works with them.

"We absolutely recommend breastfeeding, even if the mother is malnourished, unless acute malnourished," she said.

“Mothers who often get formula, they rely on it, the milk supply is reduced, and then they can’t get formula, or they don’t have clean water.”

Now back at home in the United States, Sandra tells about some of the painful cases she encountered at Khan Yunis and at the Al-Aqsa Martyrs Hospital in the central town of Deir Al-Balah.

A first-time mother went to the hospital before giving birth, but the Israeli air strikes meant she ended up giving birth alone with her husband at a tent camp.

For five days, it has been difficult for her to breastfeed her newborn baby. When it was finally safe to go to the hospital, it was too late to save her child.

Another woman and her baby survived a tank bombardment near her home, but shrapnel in her chest bounced, part of which cut off her milk pipe. She needs expert advice on how to continue feeding.

A mother of four responded well to help feed her premature newborn, but her tent was blown up later. Her husband was killed and a few hours later they received an Israeli military evacuation order.

When she and the child fled, the woman fainted and could not breastfeed for three days. In her case, luckily, they managed to find the baby formula.

"About the story, there are stories," Sandra said. "In general, we have experienced a huge despair, a huge growth in despair, and suicidal thoughts."

Extended families are the norm in Gaza, but in camps of displaced people, many women are not usually supported by relatives and friends when they are pregnant and then in the fight against newborns.

Sandra has worked in Gaza twice in the past year and has also provided remote advice to women. During her twin pregnancy, she approached the pharmacist Jomana Arafa.

Jomana spoke in English and said, "Yesterday I was born yesterday, Sandra, thank God, my child and I are in good condition." She named her baby boy Asser and girl Aysal.

But Jomana and her family’s joy is a terrible short life.

Three days later, her husband, Mohamed Abul-Qomasan, obtained a birth certificate for the baby, when he was informed that his wife, newborn and mother-in-law were killed during an Israeli missile strike at Deir Al-Balah's shelter.

A reporter from the Al-Aqsa Martyrs Hospital photographed Mohammed when the courtyard collapsed.

At the time, the Israeli military said it was unaware of the incident, adding that it had taken measures to target “military-only targets” to minimize harm to civilians.

For Sandra, Jomana's death, her mother and new baby "destroyed devastating, heartbreakingly heartbreaking". "I still think about it, I sobbed," she said.

In Gaza, pregnancy and childbirth were once an era of longing for expectation and excitement for most women, but now they are an era of stress and fear.

Babies do not represent the hope of a new life, but reflect the struggle for survival.