A group of thirty mothers had taken refuge in a maternity hospital in El Fasher, Sudan, as the slaughter began. Some had just delivered their newborns, while others were in the midst of labor.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “There were cries of women and children,” he recounts. “They were killing everyone inside the hospital. Survival meant running for your life.”
This horrifying event stands as among the worst examples in the two-year civil war tearing the African nation apart. Militiamen forced their way into the building, leaving dead more than 460 patients and their companions.
Rights organizations have labeled it “an unspeakable atrocity,” and a prime example of the vanishing safeguards for civilians trapped in war-torn areas in multiple global hotspots.
A Record of Violence On Childbirth Services
Although world powers are signatories to the international laws of war, which commit them to defending civilians, the past year has experienced a historic high of attacks on healthcare systems. Expectant mothers are exceptionally vulnerable due to their need for locally available medical care.
Data analysis and investigations reveal an shocking trend: nearly 300 incidents targeting or hindering places and people associated with childbirth over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These are not standard wartime hazards. They form a deliberate strategy of violence against reproduction.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where a vast number of expectant mothers are stranded.
Deaths have occurred, blocked from reaching help, or compelled to deliver in dangerous and unsanitary conditions. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 taken hostage, and 101 taken into custody—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
The numbers are probably a grave undercount, as they only include incidents covered by the media. In many conflict zones, information is scarce.
Last year, analysis showed that 50% of women who lost their lives in maternal circumstances lived amidst hostilities. This underscores a catastrophic reality.
Beyond killing women and staff, these attacks are wrecking hospitals and wards, jeopardizing the future to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as a factor in accusations of genocidal acts.
Despite periods of calm, doctors report that women and children continue to die from medical shortages, owing to desperate lacks of medicine and equipment. Accounts describe women giving birth in rubble because hospitals were out of reach.
“Direct shelling hitting the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or seeking to affect birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 hospitals for mothers and babies have been damaged or destroyed in Ukraine. Journalism from conflict zones describe births taking place in basements and extreme psychological pressure leading to birth complications.
“We are being singled out,” claims 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,” states a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
Accountability Evaporates
For the more than 676 million women living close to deadly warfare, there are few safeguards and rare trials for atrocities for those assaulting reproductive health.
This void of justice has fostered a “culture of impunity,” explains a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, can be understood as acts of genocide by preventing births.”
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 scarce because of a communication blackout from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, causing fatalities among patients and staff.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have faced detention, death, or harm over the past two years of civil war.
The Collapse of Safe Childbirth
A large proportion of mother deaths are averted with basic healthcare, but war collapses medical infrastructure. Rights groups note that anxiety is forcing women away from facilities once considered safe, resulting in risky home births devoid of emergency care.
“The deliberate attack on maternity wards speaks to a larger and alarming strategy: the use of attacks on medical facilities as a means of intimidation and to destroy community bonds,” says 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.”
