A group of thirty mothers were seeking shelter in a childbirth facility in El Fasher, Sudan, as the slaughter began. Several had recently given birth, while others were actively in labor.
Present at the hospital after dark, 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. “They were killing everyone inside the hospital. Survival meant running for your life.”
This appalling incident stands as one of the most shocking examples in the two-year civil war tearing the North African nation apart. Armed soldiers raided the hospital, reportedly killing more than 460 innocent people inside.
Rights organizations have labeled it “an act of unspeakable brutality,” and a prime example of the deteriorating protection for civilians caught in conflict zones in several nations at war.
A Record of Violence On Childbirth Services
Despite every significant nation have agreed to the Geneva conventions, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of assaults against medical infrastructure. Women undergoing childbirth are particularly at risk due to their dependence on locally available medical care.
An investigation of records uncover an unprecedented scale of attacks: nearly 300 violent acts against places and people associated with childbirth over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“These incidents do not represent inevitable outcomes of conflict. They form a systematic assault on childbirth.”
The majority of these incidents have happened in regions embroiled in intense conflict, where countless of expectant mothers are stranded.
Deaths have occurred, denied medical attention, or forced to give birth in deplorable situations. 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
The numbers are probably a significant underestimate, as they capture solely incidents covered by the media. In many conflict zones, reporting is limited.
Last year, it was reported that 50% of women who lost their lives in maternal circumstances lived amidst hostilities. This underscores a devastating pattern.
Beyond killing women and staff, these attacks are wrecking hospitals and wards, posing a long-term threat to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as one reason behind genocide allegations.
Following truces, doctors report that women and children are still perishing from medical shortages, owing to severe deficits of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals could not be reached.
“Direct shelling hitting the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or seeking to affect birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities have been struck and ruined in Ukraine. Journalism from conflict zones describe births taking place in basements and skyrocketing stress leading to birth complications.
“The attacks on us are intentional,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The truth of the matter is, every facility is now a potential target,” notes a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris may hit a hospital.”
A Culture of Impunity
For the over half a billion females living within range of fighting, there are few safeguards and even fewer war crimes prosecutions for those targeting maternity care.
This void of justice has led to a “environment where anything goes,” explains a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by preventing births.”
Additional Hotspots
In El Fasher, the area was isolated from 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 damaged a maternity hospital, causing fatalities among patients and staff.
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 Collapse of Safe Childbirth
The majority of childbirth fatalities 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 without skilled assistance.
“The deliberate attack on maternity wards indicates a wider and more disturbing trend: the use of violence against hospitals as a means of intimidation and to destroy community bonds,” says a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘harmful to the enemy’, which has increasingly been used as a justification.”
