At the Rehema Health Center in Goma, Ernestine Baleke says she is three months from giving birth but does not know how she will afford the delivery. Her face overcome with worry, she wonders how she will bring her ninth child into the world.

The conflict that flared this year has left many medical supplies stranded beyond the front line. Infrastructure like running water has collapsed, along with the economy in Goma, the region's humanitarian and commercial hub.

And now the one glimmer of hope for mothers — a free maternity care program offered by Congo's government — has ended after it was not renewed in June.

Freddy Kaniki, deputy coordinator of M23, asserted to the AP that the free maternal care “was not renewed because it was a failure.”

Congolese officials did not respond to questions.

"We wonder how we are going to manage. In any case, we need help from the authorities, because we risk dying at home as a result of hunger and the pregnancy,” Baleke said.

She is one of many women in eastern Congo who say they can no longer afford maternal care. Under the Congolese government, consultations and treatment for illnesses and at-risk pregnancy in Goma had been covered, but those services have ended.

Health workers say previous funding helped increase hospital deliveries.

Head nurse Franck Ndachetere Kandonyi at the Afia Himbi Health Center said the program raised numbers from as low as five deliveries a month to more than 20. He said women came in greater numbers because they knew they would not be charged.

“It was a good project, because it helped us boost our maternity statistics,” Kandonyi said, and added that since funding collapsed, attendance has fallen sharply.

Earlier this year, M23 fighters seized Goma and Bukavu, two key cities in eastern Congo, in a major escalation of the conflict.

Since 23 January 2025, intensified fighting between the Congolese armed forces and Rwanda-backed armed groups in and around Goma has triggered a major humanitarian crisis, leading to the collapse of public institutions, the internal displacement of over 700-thousand people (as reported by the UN Office for the Coordination of Humanitarian Affairs) and widespread disruption of essential services.

Aid groups warn that maternal mortality often rises in conflict zones due to delayed access to healthcare and the collapse of emergency obstetric services. With widespread unemployment, and reduced medical support, health workers here say women are increasingly giving birth at home - risking preventable complications and deaths.

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AP Video by Justin Kabumba