There is a quiet change underway in Israel’s healthcare system.
It didn’t arrive with a press conference or a public debate. It came in the form of a draft document, technical, bureaucratic, easy to overlook. But for many women, its impact would be anything but abstract.
The Ministry of Health is proposing changes to the supplementary health insurance system that would remove or severely limit access to services many women rely on during pregnancy, birth, and early motherhood. These include childbirth preparation, postpartum support, lactation guidance, and other forms of care that help women navigate one of the most vulnerable periods of their lives.
On paper, this is about budgets and efficiency. In reality, it is about whether women are seen and supported during one of the most physically and emotionally demanding transitions they will ever experience.
I work with women every day. I hear their stories, not in headlines, but in quiet conversations. Women who are terrified before birth and calmer after one honest conversation or a birthing course. Women who avoid unnecessary interventions because someone took the time to explain their options. Women who recover faster, cope better, and feel less alone because they were supported, not rushed.
These interactions are the foundation of safe care and define the midwifery model itself. Continuity, presence, and trust are not optional; they are evidence-based pillars of maternal health and safety.
Yet under the proposed changes, many of these services would no longer be funded unless delivered through limited contractual arrangements. In practice, this means access will depend on where you live, what you can afford, and whether your area happens to have approved providers. For many women, especially in the periphery, that access simply will not exist.
Those who can afford to pay privately will continue to receive support. Those who can’t will be left to manage alone.
This is how inequality deepens, not through dramatic cuts, but through policy decisions that sound reasonable while quietly shifting responsibility onto families, mostly women, at their most vulnerable moment.
And this is happening now, of all times.
Women are navigating pregnancy, birth, and early motherhood amid prolonged uncertainty, war, loss, and collective strain. Many are carrying far more than just the physical demands of pregnancy. In moments like these, access to supportive, preventive care is not a luxury. It is a stabilizing force.
To weaken that support now is not just a policy choice. It is a failure to recognize what women are carrying, physically, emotionally, and socially, and how deeply care matters when resilience is already stretched thin.
The justification offered is efficiency. But anyone who works in healthcare knows that prevention is not wasteful. It is cost-effective. Women who are supported through pregnancy, birth, and the postpartum period are less likely to experience trauma, complications, or mental health crises. Their babies do better. Their families do better. The system does better.
What is being lost here is not just a set of services, but a philosophy of care, one that understands health not only through procedures and diagnoses, but through continuity, trust, and human connection.
Israel prides itself on innovation, resilience, and care for its people. But real strength is not measured only in technology or efficiency. It is measured in prevention, health outcomes, and the long-term value created when systems invest early rather than react late.
This proposal is still a draft. That matters. It means there is still time to ask hard questions, to listen to women, and to ensure that financial responsibility does not come at the expense of dignity and care.
Because once these supports disappear, rebuilding them will be far harder than preserving them now.
And because the health of women is not a niche issue, it is the foundation of the health of our society.
Gila Zarbiv is a certified nurse midwife with a master’s in women’s health and a PhD candidate at Ben-Gurion University of the Negev, specializing in Global Health Systems Management and Implementation Science. A dedicated advocate for midwifery models of care, she has held leadership roles with the Israel Midwives Association and the International Confederation of Midwives. As a doctoral fellow at the Israel Implementation Science and Policy Engagement Centre (IS-PEC), her work bridges research and policy to transform maternal health systems globally.
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