Today, May 10, is Mothers’ Day.A few hours after undergoing a caesarean section, a Rohingya woman is carried back to her shelter on a makeshift stretcher, a table lifted by her relatives navigating narrow, uneven paths through the camp. There is no ambulance to take her home. Global frameworks on reproductive rights, maternal health and safe motherhood are built on a set of assumptions: that pregnancy can be supported through access to healthcare, functioning institutions, and a degree of choice and agency.In the Rohingya camps, these assumptions collapse. Conversations with Rohingya mothers, pregnant women and community based human rights defenders in Cox’s Bazar camps in Bangladesh that this author had reveal a different reality: motherhood here is not anchored in certainty of care, of safety, or of a secure future, but is shaped by constraint, negotiation, and endurance. The indignity of basic needsThe overwhelming majority of Rohingya families rely on shared toilets, used by dozens of households. While a recent water, sanitation and hygiene report estimates usage of approximately 18 persons per latrine and 37 per bathing cubicle, women I spoke with reported far higher figures, with 20–40 families often sharing a single toilet. There is no running water; women must carry water from their shelters each time they use these facilities. The toilets are not gender segregated.For pregnant women, this is not a minor inconvenience. It is a daily ordeal. The facilities are squat-based pit latrines, physically difficult to use in later stages of pregnancy. “At seven months, it is very hard to sit like that,” one woman explained to me. Pregnancy requires more frequent toilet use, which means repeated trips of five to 10 minutes each way and in the mornings, a queue of at least five people waiting.Toilets at the Rohingya settlement at Cox’s Bazar. Photo: Rimas Khan.For adolescent girls and younger women, carrying water to the toilet during the day can be a source of awkwardness, embarrassment, drawing unwanted attention. Many therefore wait until after dark, walking through poorly lit areas, often over long distances, under conditions that significantly increase the risk of gender-based violence. The lighting situation is about to get worse. The camps run on solar panels, and with monsoon season approaching, Showkutara, a human rights defender who is eight months pregnant, is clear-eyed about what that means: “There is going to be a lot of darkness.” Disconnect between commitment and realityDoctors and paramedical staff are not consistently available, particularly at night. Ambulance services exist in principle, but in practice remain inaccessible to most, delayed by layers of questioning and approvals that undermine their purpose entirely in urgent situations.Rimas Khan, a human rights defender, described the process: “When you call for an ambulance, there is a lot of back and forth. We are asked to explain medical history in detail. The whole point of an ambulance is emergency care, but most people cannot access one. For those who can, there are repeated questions, delays, and then approval is required from higher authorities.”In practice, this means that pregnant women and those who are ill must often make their way to hospitals on foot even in situations that require urgent care.Policy frameworks reflect a similar disconnect between commitment and reality. The most recent Joint Response Plan for the Rohingya population promises targeted, high-quality nutrition and care for pregnant and breastfeeding women. Yet it offers no clarity on how these policies operate on the ground: how a woman in labour reaches a clinic, how she returns home after undergoing surgery, or whether the nutrition she is promised is accessible to her. Hospitals don’t feel safe eitherAlthough authorities increasingly require women to give birth in hospitals partly to facilitate birth registration, this shift is not always experienced as safer. Women describe being subjected to family planning procedures without meaningful consent and being rushed into caesarean sections without adequate explanation.Showkutara explained why many women are hesitant: “We are not equipped to deal with these operations. We have to leave the hospital immediately, return home, and manage without rest or care. There is a risk of infection, but no support, no nutritious food to heal, no proper sanitation, nothing.”This is why many women continue to prefer giving birth in their own shelters, despite significantly higher maternal mortality rates among Rohingya refugees in Cox’s Bazar compared to Bangladesh’s national average. What appears, from a policy perspective, as resistance to institutional care is, in reality, a response to a system that fails to account for recovery, dignity, and consent.Another human rights defender recounted her own experience during a previous pregnancy. After experiencing severe pain, she went to a hospital where she was told she had a miscarriage. She described being made to wait for nearly 12 hours without treatment, until her father intervened, asking staff whether they intended to let her die before they finally attended to her and managed her pain. She added that hospitals are often severely understaffed and overburdened.Rohingya settlements at Cox’s Bazar. Photo: Rimas Khan.What rations don’t coverFood access reveals similar design failures. Recent humanitarian funding cuts have reduced rations across the camps, with families receiving between seven and twelve US dollars’ worth ration per person per month. This reduction comes in a context of heightened food insecurity, rising malnutrition and where Rohingya communities do not have a recognised right to work, making this allocation the primary and often only source of sustenance. Monthly rations consist primarily of rice, lentils, oil, onions, and garlic. No vegetables, fruit, eggs, or meat. A nutritional supplement is distributed to pregnant women, but it is limited in both quantity and quality.Accessing even this requires physical effort. Where a household includes a pregnant woman, elderly members, and young children but no adult man, there is often no alternative: the pregnant woman must travel to the ration centre herself. Current rules require in-person biometric verification by an adult household member, and it cannot be done on behalf of others. Women must then carry the full weight of the rations home. In practice, the burden of access falls on those least able to bear it.‘They say we give birth like animals’The failures of infrastructure are compounded by how Rohingya motherhood is perceived and spoken about by those in positions of authority. “They say our only responsibility as Rohingya women is to give birth. They tell us: this is not even your country, why are you giving birth here? Is it to get more rations? They say we are giving birth like animals,” a woman told this author.When asked whether women are pressured by their partners to have more children, she pushed back firmly against the idea that this is culturally predetermined. “Just like in any community, there are all kinds of men. There are understanding husbands where we discuss, we think about the future we can offer our children, we plan together. And there are also men who force women. But that is not something unique to us.”To frame Rohingya motherhood as inherently excessive or irresponsible is both inaccurate and harmful. It shifts attention away from the structural conditions that constrain choice, placing blame instead on the women themselves.Motherhood against erasure Beyond these material conditions, Rohingya motherhood is shaped by deeper structural insecurities. Mothers navigate the risks of human trafficking, kidnapping, early and coerced marriages, and the forced recruitment of their sons. Children are born into statelessness, inheriting not only legal exclusion but a future marked by profound uncertainty. Across healthcare, sanitation, and food distribution, a clear pattern emerges – needs are barely acknowledged at the level of policy and insufficiently, sometimes catastrophically accounted for in design and delivery.To raise a child in a camp, to pass on language, memory, and identity without land, legal status, and institutional support is to refuse erasure. It is to insist on a future in circumstances designed to foreclose one. Showkutara knows this. Rimas knows this. All the Rohingya mothers know this. Jayalakshmi Itla Ragiri is an Associate Lawyer at International Justice Counsel (IJC), a public interest strategic litigation firm. She is a Chevening Scholar and holds an LLM from SOAS, University of London. The views expressed are the author’s own and do not necessarily reflect those of the organisation.