The first siren sounded at 8:10 this morning. The entire nation, in one familiar movement, stood up and moved into the safe room. Phones charging. Water bottles and snacks lined up. Families hunkered down. The country sealed itself inside reinforced concrete, waiting.

Then my beeper went off.

Pregnant woman, contractions, eight minutes away.

I kissed my children, pushed open the safe room door, and ran to my car.

While so many of us are pressed against safe room walls, another Israel is moving, quickly, quietly, and with purpose.

As bombs fall, dispatchers are taking calls in calm tones. Drivers and ambulances are cutting through roads. Medics and paramedics are assessing scenes and making rapid decisions. Nurses and physicians are receiving a constant stream of patients. Hospital teams are cleaning, sterilizing, documenting, resetting the room for the next person. A whole chain of people leaving their own families behind reinforced metal doors so that someone else’s family can survive the hour.

War teaches us to measure time in seconds, from siren to shelter, from boom to silence. But women’s bodies do not obey that clock, and women’s health emergencies are not generic emergencies. That is why, in this chain of responders, there is a midwife.

Midwifery is not only pregnancy, birth, and postpartum. The World Health Organization (WHO) states that midwives provide 90 percent of essential sexual, reproductive, maternal, newborn, and adolescent health services (SRMNAH).

That is not a slogan. It is a blueprint. Because if midwives are meant to provide essential health care across the entire women’s health continuum, then they cannot be confined to hospitals. They need to be where emergencies begin, wherever women are. That is why the Israel Midwives Association, together with Magen David Adom and United Hatzalah, built a simple protocol: when the emergency is women’s health, a midwife is dispatched.

A woman in labor needs assessment, judgement, triage, and a plan that stays flexible minute by minute. Sometimes the safest decision is urgent transport. Sometimes it is safer to stay where she is and manage the birth there, with someone trained to recognize what is normal, what is not, and what cannot wait. Bleeding needs a clinician who understands what can be watched and what must be escalated immediately. Postpartum symptoms can change quickly. Newborn transitions can be delicate. Sexual assault requires immediate, trauma informed care and a safe pathway to support. These are moments where outcomes are shaped not only by equipment, but by skilled decisions made early.

Exactly seven minutes later I arrive and introduce myself.

My name is Gila Zarbiv. I am a midwife. I am here with you, and I will not leave you.

She is in her third pregnancy, preparing to have her second child. Her contractions are every two minutes. Her vital signs are stable. She is sweating through pain and still manages a strained smile. She tells me she is feeling pressure and asks if I can examine her. Everyone steps respectfully out of the room. She is one centimeter dilated, with a cervix that feels soft and thinning. While we wait for the ambulance, I apply counter pressure to her lower back and hips. I coach her breathing and positioning through each contraction. I explain what we are watching for and what would change our next step. I ask questions and answer hers. We sway and breathe together, one contraction at a time.

When the ambulance arrives, we transfer her with a plan: what we know, what we are watching, and what to do if anything changes on the way. She is not just being transferred. She is being cared for by the highest global standard of care.

I have delivered a 33 week baby at home when birth began in minutes.

I have seen massive bleeding, including pregnancy loss, with small children watching cautiously nearby as their world changed.

I have met women in early labor and advanced labor. I have met women after birth. I have responded to severe pelvic pain, sudden heavy bleeding, and sexual assault. I have met women in those suspended moments where you can feel the room holding its breath, waiting for someone to say what is happening, and what we are doing next.

That is my job. And that is why midwifery must be integrated into emergency response, especially in war. Integration turns expertise into a guarantee, not a coincidence.

Research shows that in times of war women hesitate. They minimize. They wait. They tell themselves it is probably nothing or they are not urgent enough. They tell themselves they should not be the reason an ambulance moves while sirens are sounding, or that stepping outside is not worth the risk.

So let me say this directly to the women of Israel, pregnant or postpartum, and to every partner listening from the safe room doorway, to the woman timing contractions, to the woman bleeding, to the woman who has not felt her baby move the same today, to the woman in the first weeks after birth, to the woman recovering from loss, to the woman in pain, and to the woman who has been hurt and does not know where to turn.

Do not hesitate. Call.

And know this: on the other end is not only a dispatcher. There is a midwife, trained for exactly this moment, ready to come to you, assess you, make decisions with you, and stay with you through what happens next.

By now the world has learned that Israel is resilient. But resilience is not only the ability to withstand constant attacks. Resilience is also whether a woman can access care when she needs it most. We cannot control when the sirens sound. But we can decide what kind of country we are while they do. A country where women do not have to choose between safety and care. A country where women’s health expertise is part of the emergency system, not an afterthought.

Because birth does not stop when bombs fall.

© The Times of Israel (Blogs)