Dozens of women were seeking shelter in a maternity hospital in El Fasher, Sudan, as the slaughter began. Some had just delivered their newborns, while others were experiencing childbirth.
Present at the hospital after dark, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “I heard the screams of women and children,” he recounts. “A massacre was taking place inside the hospital. We who were able to escape, did so.”
This brutal attack stands as a particularly egregious examples in the protracted internal conflict tearing the African nation apart. Armed soldiers stormed the facility, leaving dead more than 460 innocent people inside.
Rights organizations have labeled it “an unspeakable atrocity,” and a clear case of the collapse in safety for civilians living amidst warfare in several nations at war.
An Unprecedented Assault On Childbirth Services
While all major powers have agreed to the international laws of war, which commit them to defending civilians, the past year has seen a record number of violence targeting health services. Mothers in labor are highly exposed due to their need for locally available medical care.
Data analysis and investigations show an unprecedented scale of attacks: nearly 300 incidents targeting or hindering maternity care facilities, staff, and pregnant women over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These are not standard wartime hazards. They constitute a pattern of reproductive violence.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where a vast number of expectant mothers are stranded.
Women have been killed, denied medical attention, or forced to give birth in dangerous and unsanitary conditions. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 kidnapped, and 101 detained—sometimes while assisting births.
The Global Crisis in Maternal Health
These figures likely represent a grave undercount, as they only include incidents covered by the media. In many war-torn areas, information is scarce.
Last year, it was reported that half of all women who died during pregnancy or childbirth were in a conflict area. This underscores a horrifying trend.
In addition to the loss of life, these attacks are destroying critical infrastructure for mothers and babies, jeopardizing the future to demographic stability.
The Situation in Gaza
In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as one reason behind accusations of genocidal acts.
Following truces, doctors report that women and children continue to die from medical shortages, owing to severe deficits of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals were out of reach.
“Direct shelling targeting the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or trying to alter birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities have been damaged or destroyed in Ukraine. Reports from frontline hospitals describe births taking place in basements and skyrocketing stress leading to maternal health issues.
“We are being singled out,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The reality is, every facility can be under attack now,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris could impact a hospital.”
Accountability Evaporates
For the over half a billion females living near active conflicts, there are minimal protections and a stark lack of legal accountability for those targeting maternity care.
This lack of accountability has led to a “culture of impunity,” explains a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, may constitute acts of genocide by hindering reproduction.”
Other Conflict Zones
In El Fasher, the area lacked access to humanitarian aid long before the hospital attack, with malnutrition increasing drastically, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is scarce because of a inability to report from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, killing mothers, babies, and nurses.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The End of Safe Deliveries
A large proportion of mother deaths are averted with basic healthcare, but war destroys healthcare networks. Rights groups note that terror is compelling women away from facilities once considered safe, resulting in risky home births lacking professional help.
“When childbirth centers become intentional targets speaks to a broader and more sinister pattern: the use of violence against hospitals as a means of intimidation and to tear apart the social fabric,” says a legal researcher.
“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘harmful to the enemy’, which has now become a standard defence.”
