A group of thirty mothers had taken refuge in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. Among them were new mothers, while others were in the midst of labor.
On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “I heard the screams of women and children,” he states. “A massacre was taking place inside the hospital. We who were able to escape, did so.”
This horrifying event stands as a particularly egregious examples in the two-year civil war tearing the North African nation apart. Armed soldiers stormed the facility, reportedly killing more than 460 individuals receiving care and their families.
Rights organizations have called it “a crime beyond words,” and a prime example of the vanishing safeguards for civilians living amidst warfare in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault On Childbirth Services
While all major powers have agreed to the international laws of war, which obligate them to protect civilians, the past year has seen a record number of assaults against medical infrastructure. Women undergoing childbirth are highly exposed due to their dependence on locally available medical care.
An investigation of records uncover an alarming level of violence: nearly 300 attacks on and disruptions to maternity care facilities, staff, and pregnant women over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These incidents do not represent natural consequences of war. They form a systematic assault on childbirth.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where a vast number of expectant mothers are stranded.
Deaths have occurred, blocked from reaching help, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 taken hostage, and 101 detained—sometimes in the act of delivering babies.
The Global Crisis for Mothers and Newborns
The numbers are probably a substantial underreporting, as they are limited to incidents documented publicly. In many conflict zones, reporting is limited.
Last year, analysis showed that 50% of women who died during pregnancy or childbirth lived amidst hostilities. This underscores a devastating pattern.
Apart from fatalities, these attacks are wrecking hospitals and wards, jeopardizing the future to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as a factor in declaring certain actions a genocide.
Despite periods of calm, doctors report that women and children continue to die from medical shortages, owing to desperate lacks of medicine and equipment. Agencies have reported women delivering babies amidst ruins because hospitals were out of reach.
“We’ve had rockets fired at the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or seeking to affect birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 hospitals for mothers and babies have been struck and ruined in Ukraine. Reports from frontline hospitals describe births forced underground and extreme psychological pressure leading to maternal health issues.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“The reality is, every facility faces the threat of assault,” states a medical director in Sumy. “If a drone is destroyed, the falling debris could impact a hospital.”
A Culture of Impunity
For the more than 676 million women living within range of fighting, there are few safeguards and rare trials for atrocities for those targeting maternity care.
This absence of consequences has created a “atmosphere of lawlessness,” argues a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, can be understood as acts of genocide by hindering reproduction.”
Additional Hotspots
In El Fasher, the area lacked access to humanitarian aid long before the hospital attack, with malnutrition spiking dangerously, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is limited by a communication blackout from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, resulting in tragic loss of life.
In Myanmar, clinics have been attacked and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The Collapse of Safe Childbirth
A large proportion of mother deaths are avoidable with standard medicine, but war collapses medical infrastructure. Rights groups note that anxiety is forcing women away from facilities once considered safe, pushing them toward risky home births devoid of emergency care.
“If maternity hospitals are being deliberately targeted points toward a broader and more sinister pattern: the use of attacks on medical facilities as a means of intimidation and to break societal cohesion,” observes a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘prejudicial to the opposing side’, which has increasingly been used as a justification.”
