The largest U.S. Department of Defense hospital abroad is pausing its labor and delivery services until further notice to focus on the needs of the conflict across the Middle East.

The Landstuhl Regional Medical Center, located near Ramstein Air Base in Germany, is temporarily referring some labor and delivery patients to other hospitals within the local community, hospital officials told Military Times on Thursday.

The medical center sent a notice about the halt in those services to Landstuhl patients through a Tuesday memorandum that circulated on the unofficial Air Force amn/nco/snco Facebook page.

“Our staff is in direct contact with impacted patients to provide additional information and facilitate a smooth transition to our healthcare partners,” center officials told Military Times in a statement.

The memo states that the closure of labor and delivery is due to the hospital’s “primary objective.”

Although the memo doesn’t elaborate on what that objective is, the hospital’s primary role in critical combat care is to treat patients that are injured during training or combat operations throughout Europe, Africa and the Middle East, according to the hospital’s website.

During the ongoing U.S. military operations in Iran, the hospital is expected to continue its role in combat care.

Six U.S. service members were killed in an attack by Iran on Sunday in Port Shuaiba, Kuwait. Others have been listed as “seriously wounded” by U.S. Central Command as Iran continues to strike U.S. military installations across the Middle East following the joint U.S.-Israeli attack.

CENTCOM said Monday that 18 troops were wounded thus far, a large increase from the five reported over the weekend.

Officials did not detail the extent of the injuries or whether the wounded service members were taken to any military hospitals in Germany or the U.S.

Landstuhl is the largest American medical facility outside the U.S., the only American College of Surgeons-verified level II trauma center overseas and the only U.S. trauma center associated with a foreign trauma network, according to a 2023 U.S. Army release on the center’s 70th anniversary.

The hospital will continue to see labor and delivery patients for prenatal appointments until 36 weeks, according to the memo, and patients that are further along than 36 weeks are urged to contact the hospital about what steps to take next.

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The hospital’s labor and delivery unit utilizes nurses, midwives, obstetricians and medical technicians throughout a patient’s birth experience, according to its website.

Hospital officials told Military Times that patients are encouraged to contact the medical center’s patient advocate with questions they may have regarding their care.

“The decision-making occurred at a very high level and we are saddened we cannot provide your care,” the memo reads.

Hospital officials declined to comment on which office made the decision.

There is no current timeline for when labor and delivery services will resume, per the memo.

The Israeli military says it has targeted Iranian missile sites in overnight attacks and heavy explosions have been heard in the capital Tehran, as the US-Israeli war with Iran continues for a tenth day.

Iran, meanwhile, has carried out further missile and drone strikes targeting Israel and the Gulf states.

Officials in Bahrain say an Iranian drone attack south of the capital, Manama, wounded at least 32 people. The country's energy company also reported that a drone attack caused a fire at its largest oil refinery.

Qatar, Kuwait, the United Arab Emirates (UAE) and Saudi Arabia reported new attacks overnight. In Israel, emergency services said one woman was injured by flying debris following an Iranian missile attack.

The US-based Human Rights Activists News Agency (HRANA) says 1,205 civilians are reported to have been killed in Iran since 28 February. Seven US service personnel have been killed since the start of the conflict, according to the Department of Defense.

Where in Iran has been hit by US and Israeli strikes?

The first US-Israeli strikes on Iran began on 28 February with Israel's military saying it targeted Iran's leadership and its military infrastructure. The former Supreme Leader of Iran, Ayatollah Ali Khamenei, was killed in Tehran during the initial strikes.

On Sunday evening the Israel Defense Forces (IDF) said "approximately 3,400 strikes" had been carried out so far with more than 150 Iranian defence systems disabled.

BBC Verify has seen footage of smoke and fires at four Iranian oil facilities. IDF spokesman Lt Col Nadav Shoshani said such sites were a "legal, military target"

Iran's foreign ministry said the strikes had released "hazardous materials and toxic substances into the air" and accused Israel of "poisoning civilians".

BBC Verify has so far confirmed visual evidence of more than 110 attacks across the whole of Iran, including at least 49 strikes in Tehran.

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Satellite imagery reviewed by BBC Verify since the conflict began on 28 February has shown:

• Damaged aircraft and large burn marks on the tarmac at Mehrabad airport in Tehran

• Damage to a naval and air base in the southern port city of Bushehr

• At least 11 Iranian naval vessels damaged or destroyed by US and Israeli strikes on the Konarak and Bandar Abbas naval bases

• Damage to a nuclear facility at Natanz and at least three Iranian missile sites

In Minab, in the south of Iran, at least 168 people including children were killed at a girls' school when it was hit on 28 February, Iranian authorities said. Two buildings can be seen in satellite imagery - an Iranian Revolutionary Guard Corps base has been completely flattened and the school building has partially collapsed.

Analysis of the imagery reveals multiple strikes and burn marks around the school suggesting it was hit more than once.

Israel strikes Lebanon after Hezbollah attack

Israeli forces have carried out air strikes in Lebanon targeting Hezbollah, the militant group that has long been backed by Iran. Hezbollah launched missiles towards Israel on 2 March following the killing of Khamenei.

Israel said it carried out a "precise strike" on the Lebanese capital Beirut on Sunday targeting commanders from the Quds force - the foreign operations arm of Iran's Revolutionary Guards. The Lebanese health ministry said four people died in an Israeli strike on a hotel in central Beirut.

According to the health ministry, 394 people have been killed in the past week from Israeli strikes.

A missile attack on 1 March, which Israel said came from Iran, killed at least nine people and injured 27 others in the city of Beit Shemesh, according to emergency services.

On Monday, the the IDF it was striking Hezbollah infrastructure in the Dahieh area of Beirut. An IDF spokesman earlier urged people to evacuate, saying they will "act forcefully" against "terrorist infrastructure".

• Iran school and nearby military base struck multiple times, satellite image reveals

• Satellite images show Iranian navy and nuclear sites hit by US-Israeli strikes

• Why did US and Israel attack Iran and how long could the war last?

Iranian strikes across the Middle East

The governments of Saudi Arabia, Kuwait, Bahrain and the UAE all reported what they said were Iranian missile and drone attacks on Sunday.

Kuwait said it contained a major fire in a government office block following a reported attack during the early hours of the morning.

The UAE said its air defences intercepted 16 ballistic missiles and 113 drones on Sunday. The latest attack came after an apparent drone strike hit Dubai International airport on Saturday. The UAE said that in the past week 238 missiles and 1,422 drones had been launched at the country.

On Monday 9 March, Bahrain said a drone attack injured 32 civilians - the highest number of casualties in a single incident in the Gulf states since the war began.

Oman, Qatar, Saudi Arabia and Iraq have also come under attack since the war began on 28 February.

Shipping in the Gulf has been severely disrupted after Iran threatened to "set fire" to vessels in the Strait of Hormuz through which 20% of the world's oil and gas flows.

Attacks outside the Middle East

The US-Israeli war with Iran has also spread beyond the region.

• An Iranian warship was sunk by a US submarine off Sri Lanka, according to the Pentagon. Eighty-seven of the 130 people onboard were killed, Sri Lankan officials said

• Azerbaijan accused Iran of launching drones that it said injured two people in the western territory of Nakhchivan on Thursday. Tehran denied being involved

• A UK air base on the island of Cyprus was hit by a drone on 1 March which British officials believe was launched by Hezbollah forces from Lebanon

This story is being updated daily by BBC Verify.

• Seven American service members have been killed as part of combat operations against Iran.

• Others have been seriously wounded.

• The US and Israel began major combat operations against Iran on February 28.

An American service member injured in an Iranian counterattack on Saudi Arabia one day after the start of major US-Israeli combat operations against Iran has died, the US military said Sunday.

"This is the seventh service member killed in action during Operation Epic Fury," US Central Command said. "Major combat operations continue."

CENTCOM said on March 1 that three US service members were killed and five were seriously hurt during combat operations against Iran. It marked the military's first acknowledgement of any US losses since American forces began striking Iran alongside Israel.

One of the injured service members succumbed to their injuries, the military said March 2.

Defense Secretary Pete Hegseth told reporters last Monday that the four service members were killed at a fortified tactical operation center while they were engaged in air defense against Iranian munitions.

Later that day, two US service members who had been missing after Iranian strikes were declared dead. CENTCOM, which oversees Middle East operations, said American forces recovered the remains of the two service members from a facility that Iran struck.

The latest loss brings the American military death toll from the war with Iran to seven. Nine American service members remain seriously wounded from Iranian attacks across the Middle East, a Central Command spokesperson said.

President Donald Trump has previously vowed to seek vengeance for US service members killed.

"As one nation, we grieve for the true American patriots who have made the ultimate sacrifice for our nation, even as we continue the righteous mission for which they gave their lives," he said in a video address on March 1.

"And sadly, there will likely be more before it ends. That's the way it is," Trump said. The president had warned the day before that the US could suffer losses as a result of the conflict with Iran.

"The lives of courageous American heroes may be lost, and we may have casualties. That often happens in war," Trump said in a video address to the nation. "But we're doing this — not for now — we're doing this for the future, and it is a noble mission."

The US military's March 2 casualty updates came just as it also revealed that three American F-15E fighter jets were mistakenly shot down by Kuwait in "an apparent friendly fire incident." All six crew members ejected and were safely recovered, CENTCOM said, adding that they are in stable condition.

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Dozens of people have been killed and wounded by Iranian strikes in Israel and the United Arab Emirates, and hundreds of people in Iran have been killed and wounded by US and Israeli strikes, according to local authorities.

The Israeli military said on March 1, after just one day of war against Iran, that it killed 40 senior Iranian commanders, as well as the country's Supreme Leader, Ayatollah Ali Khamenei.

US forces — on land, in the air, and at sea — have taken part in the strikes against Iran, targeting the Islamic Revolutionary Guard Corps' (IRGC) command and control facilities, air defenses, missile and drone launch sites, and military airfields.

American forces have also been involved in air defense operations to shield American assets and allies across the Middle East from hundreds of Iran's retaliatory missile and drone attacks.

Iran has fired hundreds of missiles and drones at US forces based in Qatar, Kuwait, Bahrain, and the UAE, and has also targeted most other Middle East countries, including Israel, Saudi Arabia, Oman, and Iraq.

Read the original article on Business Insider

Up to 30,000 customers of German travel agencies are affected by the war in the Middle East, a leading trade group said on Monday, as a German tour operator set up a crisis hotline and the Foreign Office scrambled to help travellers.

Anja Karliczek, the chairwoman of the tourism committee in Germany's lower house of parliament, the Bundestag, told dpa that "the safety of tourists and travellers stranded in the crisis region is naturally our top priority."

Figures from the German Travel Association suggest around 30,000 tourists are unable to fly home after the United States and Israel launched a large-scale offensive against Iran on Saturday, sparking a regional escalation as Tehran fired missiles at US bases in several Gulf states.

Karliczek expressed confidence that the authorities and the tourism industry would take the necessary steps after a quick analysis of the situation.

"Then we all hope that holidaymakers stranded in the crisis region will quickly be able to leave via regular and safe routes," she said.

German Foreign Office sending charter flights

The Foreign Office is preparing to repatriate sick people, children and pregnant women from the conflict region. It plans to send chartered planes to the capitals Riyadh in Saudi Arabia and Muscat in Oman, Foreign Minister Johann Wadephul said in Berlin.

However, the German government believes that tour operators and airlines are chiefly responsible for bringing their customers back to Germany.

Providing aircraft for particularly vulnerable groups is the second option, said Wadephul. "First and foremost, of course, the travel companies must step in. And thirdly, if all that is not enough, then we would resort to the Bundeswehr if necessary."

But Wadephul emphasized: "We have a common goal: We want to help Germans get home."

Tourists stuck is several countries

German tour operator Dertour said a low four-digit number of its customers are currently in the United Arab Emirates, Saudi Arabia, Qatar, Bahrain, Oman, Jordan, Israel and Kuwait.

Dertour, Germany's second-largest tour operator, said it is unclear how long airspace will be closed in the region.

"Guests who are currently unable to fly home or are waiting for a connecting flight due to airspace closures have been informed by us and are being looked after on site," the company said in a statement.

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Local tour guides are available to guests as contacts, it said. "The tour guides will extend hotel accommodation accordingly or provide alternative rooms in other hotels."

The company has set up a 24-hour hotline staffed by crisis teams who have been specifically trained for such situations.

Travel advice

Travellers in the affected areas are strongly advised to follow safety instructions issued by the German Foreign Office and the guidelines of the local authorities.

"We will inform our guests on site about return journeys as soon as these are possible again and will accompany our guests on their transfer journeys."

The German Travel Association also advised holidaymakers to follow the instructions of the local authorities, stay in their booked hotels and not to travel independently to airports or neighbouring countries.

Dertour cancelled all trips to the eight countries until at least Thursday. Affected guests can rebook to a later travel date free of charge or, alternatively, receive a full refund of the travel price.

Alternative flight connections are being sought for transit passengers who are unable to depart as planned due to flight cancellations.

"In cases where we are unable to offer new flight connections, free rebookings or cancellations are possible."

Flight alternatives are also being sought for guests with connections in Middle Eastern hubs whose return flights to Germany have been cancelled.

Superjumbo jet returns from the region empty

Despite tens of thousands of stranded travellers in the Gulf region, an Airbus A380 of German airline Lufthansa flew from Abu Dhabi to Munich without passengers.

According to the airline, it was not possible to carry passengers back to Germany due to a lack of cabin crew. Only the two pilots were on board the aircraft. It was not possible to get a cabin crew there on time.

"Without flight attendants, passenger transport is impossible legally and safety-wise," Lufthansa pointed out in a statement.

Lufthansa avoids Middle Eastern airspace

The Lufthansa Group is avoiding Middle Eastern airspace due to the conflict in the region, the company said on Monday.

Airspace over Israel, Iran, Lebanon, Jordan, Iraq, Qatar, Kuwait, Bahrain and the Saudi airport of Dammam will not be used by the group's airlines until at least March 8. Meanwhile, traffic over the United Arab Emirates will be avoided until March 4.

The carrier announced suspensions of flights to several airports in the region until at least March 8 shortly after the large-scale offensive was launched by the United States and Israel against Iran on Saturday.

"The safety of passengers and crews is always the top priority for the Lufthansa Group," the airline said.

Lufthansa said affected passengers can rebook to a later travel date free of charge or receive a full refund of the ticket price.

450 flights cancelled at German airports

The situation in the Middle East is having a significant impact on air traffic in Germany, with more than 450 flights cancelled at the eight largest airports in Germany up to March 5.

The German Airports Association (ADV) said on Monday that flights to Abu Dhabi, Amman, Beirut, Doha, Dubai, Erbil, Sulaimaniyah and Tel Aviv are among those affected.

Around 135,000 passengers are currently unable to travel as planned.