A group of thirty mothers had taken refuge in a maternity hospital in El Fasher, Sudan, when the massacre started. 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. “There were cries of women and children,” he explains. “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 African nation apart. Combatants raided the hospital, leaving dead more than 460 innocent people inside.
Rights organizations have described it as “an act of unspeakable brutality,” and a clear case of the collapse in safety for civilians caught in conflict zones in multiple global hotspots.
A Record of Violence On Childbirth Services
Despite every significant nation are signatories to the international laws of war, which require them to safeguard civilians, the past year has seen a record number of violence targeting health services. Women undergoing childbirth are highly exposed due to their dependence on locally available medical care.
Data analysis and investigations uncover an shocking trend: nearly 300 incidents targeting or hindering places and people associated with childbirth over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“This is not standard wartime hazards. They represent a systematic assault on childbirth.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where hundreds of thousands of expectant mothers are stranded.
Mothers have lost their lives, blocked from reaching help, or made to have their babies in dangerous and unsanitary conditions. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 abducted, and 101 detained—sometimes in the act of delivering babies.
The Global Crisis in Maternal Health
The numbers are probably a significant underestimate, as they only include incidents reported in news outlets. In many conflict zones, reporting is limited.
Last year, analysis showed 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 wrecking hospitals and wards, creating a grave danger to community survival.
The Situation in Gaza
In Gaza, the ruinous consequences on reproductive health rights has been cited by a UN commission as a factor in accusations of genocidal acts.
Even after ceasefires, doctors report that women and children continue to die from inadequate care, owing to desperate lacks of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals were out of reach.
“Our facility has endured missile strikes fired at the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or trying to alter birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been struck and ruined in Ukraine. Reports from frontline hospitals describe births forced underground and skyrocketing stress leading to problems during delivery.
“Russia is targeting us deliberately,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“In fact, every facility can be under attack now,” comments 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 close to deadly warfare, there are minimal protections and even fewer war crimes prosecutions for those targeting maternity care.
This lack of accountability has fostered a “environment where anything goes,” argues a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, may constitute acts of genocide by destroying a group's future.”
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 restricted due to a lack of access from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, resulting in tragic loss of life.
In Myanmar, clinics have been attacked 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
The majority of childbirth fatalities are preventable with routine care, but war collapses medical infrastructure. Rights groups note that terror is compelling women away from facilities once considered safe, pushing them toward risky home births lacking professional help.
“The deliberate attack on maternity wards points toward a wider and more disturbing trend: the use of attacks on medical facilities as a means of intimidation and to break societal cohesion,” notes 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 ‘prejudicial to the opposing side’, which has now become a standard defence.”
