SHAVEI ZION — Roni Tenne Cohen, a Galilee Medical Center midwife, kept her hands on Shira Weiss’s belly during a recent home visit in their village in Western Galilee, about 16 kilometers (10 miles) from the border with Lebanon.

“The baby is in an excellent position for 37 weeks,” Cohen said, reassuring  Weiss.

Then, after listening to the baby’s heartbeat with a portable fetal monitor, Cohen passed her a bowl of green grapes. “Now is the time to try to take care of yourself.”

As Hezbollah continues to fire its daily barrages into northern Israel, for the past 10 months, expectant mothers are not only concerned about the baby inside them, but also fearful about what might happen if the terror group’s attacks escalate into full-blown war, preventing them from reaching a hospital in time for delivery.

To help them prepare for an emergency birth at home, a volunteer project in the Western Galilee and the Golan Heights called First Contractions was begun in April. It matches expectant mothers with volunteer midwives who live near them.

“We instruct them for the worst-case scenario: if we become a ‘separate island,'” Cohen said. That would mean that damage to infrastructure and communication shutdowns, mass casualties and destruction would prevent women from reaching a hospital or getting any medical assistance.

Cohen and other midwives feel an even greater sense of urgency to help pregnant women as Hezbollah threatens a large-scale attack in retaliation for the recent killing of Hezbollah deputy chief Fuad Shukr in Beirut. Iran has also vowed to avenge the killing of Ismail Haniyeh in Teheran.

So far, Hezbollah attacks have resulted in 26 civilian deaths on the Israeli side, as well as the deaths of 18 IDF soldiers and reservists.

Sponsored by Magen David Adom (MDA), the Israel Midwives Organization, and the Jewish Federations of North America, First Contractions has enrolled 60 midwives, among them Jews, Arabs, and Druze, reflecting the diverse character of the Western Galilee and the Golan Heights.

Local regional councils spread the word to pregnant women and so far about 280 mothers have signed up to receive the free service.

Cohen said that if labor begins and women are unable to reach a medical center, she and other midwives will do “their best to reach them or provide phone support.”

She said the midwives can also conduct a home visit after the birth. She has guided five women through their pregnancies so far.

The MDA dispatch system has all the midwives’ contact information so that they can be dispatched to help with births at home. The midwives also received first aid kits, including hand-held Doppler ultrasound devices, oxygen tanks, and other necessary medical equipment to use during the pregnancy, at the time of birth, and afterward for check-ups if there are no available medical services.

“If I can’t reach Shira’s house because of the bombing, then I’ve instructed her and her husband on how to deliver their baby at home,” Cohen said. “I told her the most important thing, which is not to pull out the baby with force, just wait for it to come naturally.”

“Roni calmed me down,” Weiss said. “She explained what’s urgent, what isn’t, and how to handle the birth gently if it comes to that. We have towels and sheets ready to keep the baby warm.”

In 2023, MDA transported 16,283 women by ambulance to hospitals. Another 1,062 labored with help from MDA teams in their homes or on their way to the hospital. By working with local midwives, the first responders can prepare for emergencies when MDA teams are unable to reach the birthing women.

The MDA recently held two training sessions where 37 midwives from the area received equipment and learned how to operate and use MDA’s emergency dispatch system.

“We gave the volunteer midwives the necessary medical equipment in case we can’t reach a birthing woman or transport her to a hospital,” said Yossi Halabi, Manager of MDA’s First Response Division. “Midwives are the experts.”

In Israel, midwives are registered nurses who study for six years to treat women during pregnancy and for six weeks after giving birth. Most pregnant women do not meet their midwives until they arrive at the hospital.

Ragda Faris Rabah is a midwife at Galilee Medical Center and a resident of the Druze village of Kisra-Sumei in Western Galilee.

She has been paired with six women in her geographical area. She gives instructions on birthing to the pregnant women and another person, “a neighbor, mother, relative or husband,” in case they have to give birth at home.

“The situation in the north is getting more and more dangerous,” Rabah told The Times of Israel. “During war, you can postpone weddings and trips, but you can’t postpone birth.”

“Women are very sensitive during pregnancy and have more anxiety,” she said, and being able to contact a midwife and talk to her can reduce stress and “make the outcome a lot better.”

“The rationale of the project is that no woman should feel isolated and alone,” Rabah said.

First Contractions is one of a series of MDA initiatives to prepare for future emergency scenarios in the aftermath of October 7. Part of the initiative includes creating community-based medical response teams to treat patients when immediate transport to the hospital is not possible, as well as formulating detailed plans for treating patients in the event of serious power and cellular outages.

The MDA hopes to expand the First Contractions project to other regions of the country.

“The project will enable pregnant women who live in the shadow of war to get to know the midwives in their region early on,” said Yifat Hadar Rubanenko, chairperson of the Israel Midwives Organization. She hopes the project will continue during peacetime as well.

On Monday evening, the day after Cohen’s visit, Weiss went into labor. She had planned to give birth at Galilee Medical Center but there were sirens warning of incoming Hezbollah rockets. Instead of driving north, toward Nahariya, she and her husband, Tal, drove south, to Carmel Medical Center in Haifa.

“I spoke to Roni by phone and she gave me advice along the way,” Weiss said.

At 9:30 p.m., Weiss gave birth to a baby boy.