Reproductive Justice
At the Mercy of the Sea: Women, Reproduction, and Europe’s Migrant Crisis

At the Mercy of the Sea: Women, Reproduction, and Europe’s Migrant Crisis

In 2015 over a million women, children, and men from conflict-ridden parts of Africa and the Middle East made their way across the Mediterranean Sea, seeking a better life in Europe. Thousands, as we now know, died in the process. In 2016 the tide of migrants, as well as casualties, only increased, and it shows no signs of abating any time soon.

Images of these refugee displacements and the resultant “European Migrant Crisis” have dominated the news over the past few years. International groups and the press have highlighted not only the voyages themselves (and most commonly the horrors of those voyages) but also what happens to refugees once they reach Europe: the European Union’s responses to refugees and asylum seekers; the xenophobic reactions of some Europeans to these travelers; the suspicions of terrorism that accompany such migrations; and even fears that male migrants will rape European women.

Harder to find, however, are stories of migrant women and their experiences. We still know little about the unique challenges faced by refugee women, and particularly those whose journeys are marked by pregnancy, lactation, and/or infant care. In 2016, at least 60% of refugee migrants were women or children.1 Around ten percent of women refugees around the world are pregnant. Their incredible migration experiences, called “A Quiet Crisis” by the Huffington Post, have been emerging only recently. In one article by the Christian Science Monitor, German rescue workers and volunteers described the death of a pregnant woman at sea, how migrant women came together to mind each other’s children during the voyage, and the anxieties of a woman who, eight months pregnant, was rescued but could not find her husband who had been traveling on the same rickety boat.

Sanaa, a Syrian refugee whose baby was born in Greece. (Lynsey Addario–Verbatim/TIME)

According to the United Nations Population Fund (UNFPF), of the thousands of pregnant women who have made the crossing to Europe in recent years, most did not likely receive adequate prenatal care before escaping conflict zones in their home countries. On the crossing to Europe, conditions are dismal for all, but pregnant women or women with infants face unique challenges. In September, a Doctors Without Borders rescue boat assisted a Syrian woman who had endured labor contractions for three days while on a rubber boat from Libya. The midwife who eventually helped deliver the infant on the rescue vessel expressed her horror at what might have happened if the woman had delivered earlier, “in that unseaworthy rubber boat, with fuel on the bottom where the women sit, crammed in with no space to move, at the mercy of the sea.”

In addition, a majority of pregnant migrants are under the age of 20, which puts them at higher risk for complications. Doctors Without Borders reports that women fleeing Syria who stop over in Lebanon on their way to Turkey and Greece have high rates of “reproductive tract infections.” The death rates for women who succumb to complications associated with pregnancy and birth on sea crossings and in refugee camps are abysmally high, reaching over 500 a day, according to recent estimates.

In 2016, at least 1,000 women fleeing Syria gave birth to infants in Greece and Macedonia. Red Cross officials recently reported that there were at least 16 pregnant women out of approximately 130 people who sought their services in one day. And, of course, the voyages of these women are far from over; Greece is usually only a stopping point along the route to other parts of Europe. Recently one Syrian woman, Tehmina, gave birth in a Greek refugee camp and then, almost immediately, continued to walk to Germany with her family.

Those women who survive their voyages and arrive in mainland Europe face additional hardships. Even if they are provided with official health services, cultural differences, language barriers, and fear of being reported to authorities continue to hinder women’s access to reproductive care.2 Reproductive women also face challenges because of their new birth environments, which present cultural ruptures for many. Some women describe as especially stressful the loss of family and community support during labor and birth, particularly the female relatives and neighbors who may have assisted at their births in their home countries.

In terms of the big picture, the results are equally troubling. Scholars have demonstrated that migrant women in Europe have significantly higher maternal mortality rates than non-migrant women.3 A 2015 report found that “81.1% of pregnant women seen by Doctors of the World across Europe in 2014 had no healthcare coverage; in London, a total lack of health-care coverage on the day of their first consultation was recorded for 94.7% of women.”4 And for those children of refugee women who are born in Europe, questions of citizenship, belonging, and identity determine their lives. Many end up being stateless: denied citizenship in their settler nations but also in their parents’ home nations. What will become of these children?

Whether the migrations of pregnant refugee women will increase or decrease remains unknown. What is clear, however, is that until it ends (if it ends), the cycle of maternal and infant deaths, inadequate reproductive health care, and trauma will persist.

(Matej Divizna/Getty)

Organizations such as the UNFPA and Doctors Without Borders, as well as news outlets, have attempted to publicize this important global issue in the past year or so. Time magazine, for example, launched “Finding Home” in late 2016. This project traces the first year of life of four infants born to migrant women, “documenting in photo and video, in print, online and on social media, the first year of this stateless generation.” Still, according to the UNHCR, “the current protection response by government agencies, humanitarian actors and CSOs are inadequate.”

The recent attention paid to this issue is only a start. The international community, led by feminist scholars, must unite to draw greater attention to the plights of pregnant and postpartum women seeking refuge in Europe.

“At every stage of the [migration] journey,” writes Leigh Danes, “people are suffering.”5 The suffering encountered by pregnant women or new mothers and their families, however, is of particular urgent concern. At stake is not only the futures of the thousands of infants born of migrant women every year but also the long-term legacies for women’s lives and health.


  1. Leigh Danes, “The Health Impacts of the Refugee Crisis: A Medical Charity Perspective,” Clinical Medicine 16.5 (2016), 438. Return to text.
  2. Sarah Fredsted Villadsen, Laust Hvas Mortensen, and Anne-Marie Nybo Andersen, “Care During Pregnancy and Childbirth for Migrant Women: How do we Advance? Development of intervention studies – The Case of the MAMAACT Intervention in Denmark,” Migration – Impact on Reproductive Health, Best Practice & Research Clinical Obstetrics & Gynaecology 32 (April 2016), 100-112; Madeline Murphy, “Editorial,” British Journal of Midwifery 23.10 (October 2015), 688. Return to text.
  3. Grete Pedersen, Anders Grøntved, Laust Mortensen, Anne-Marie Andersen, and Janet Rich-Edwards, “Maternal Mortality Among Migrants in Western Europe: A Meta-Analysis,” Maternal & Child Health Journal 18.7 (September 2014), 1628-1638. Return to text.
  4. Madeline Murphy, “Editorial,” British Journal of Midwifery 23.10 (October 2015), 688. Return to text.
  5. Danes, “The Health Impacts of the Refugee Crisis: A Medical Charity Perspective,” 438. Return to text.

Cara Delay, Associate Professor of History at the College of Charleston, holds degrees from Boston College and Brandeis University. Her research analyzes women, gender, and culture in nineteenth- and twentieth-century Ireland, Britain, and the British Empire, with a particular focus on the history of reproduction, pregnancy, and childbirth. She has published in The Journal of British Studies, Lilith: A Feminist History Journal, Feminist Studies, Études Irlandaises, New Hibernia Review, and Éire-Ireland and written blogs for Nursing Clio and Her co-edited volume Women, Reform, and Resistance in Ireland, 1850-1950, was published with Palgrave Macmillan in 2015, and her monograph on Irish women and the creation of modern Catholicism is forthcoming from Manchester University Press. At the College of Charleston, she teaches courses on women’s history and the history of birth and bodies.