A group of thirty mothers had taken refuge in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. Several had recently given birth, while others were experiencing childbirth.
Present at the hospital after dark, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, became one of the few known survivors. “The sounds of screaming reached me of women and children,” he states. “A massacre was taking place inside the hospital. Those who could run, fled.”
This appalling incident stands as one of the most shocking examples in the two-year civil war tearing the North African nation apart. Militiamen raided the hospital, leaving dead more than 460 innocent people inside.
Rights organizations have labeled it “a crime beyond words,” 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
Despite every significant nation are signatories to the Geneva conventions, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Mothers in labor are particularly at risk due to their dependence on locally available medical care.
An investigation of records show an shocking trend: nearly 300 violent acts against places and people associated with childbirth over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“These incidents do not represent standard wartime hazards. They constitute a systematic assault on childbirth.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where hundreds of thousands of pregnant women are trapped.
Mothers have lost their lives, blocked from reaching help, or compelled to deliver in dangerous and unsanitary conditions. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 taken hostage, and 101 arrested—sometimes while assisting births.
A Worldwide Emergency for Mothers and Newborns
These figures likely represent a substantial underreporting, as they only include incidents covered by the media. In many areas of fighting, communications are sparse.
Last year, it was reported that half of all women who died during pregnancy or childbirth resided in a war zone. This underscores a catastrophic reality.
Apart from fatalities, these attacks are wrecking hospitals and wards, creating a grave danger to demographic stability.
The Situation in Gaza
In Gaza, the catastrophic impact 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 continue to die from inadequate care, owing to desperate lacks of medicine and equipment. Agencies have reported women delivering babies amidst ruins because hospitals were inaccessible.
“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 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 attacked and rendered unusable in Ukraine. Reports from frontline hospitals describe births occurring in shelters and extreme psychological pressure leading to birth complications.
“Russia is targeting us deliberately,” 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,” states a medical director in Sumy. “If a drone is destroyed, the falling debris could impact a hospital.”
Accountability Evaporates
For the more than 676 million women living within range of fighting, there are minimal protections and a stark lack of legal accountability for those targeting maternity care.
This lack of accountability has fostered a “atmosphere of lawlessness,” says a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, may constitute acts of genocide by hindering reproduction.”
Additional Hotspots
In El Fasher, the area had been cut off from 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 communication blackout from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, resulting in tragic loss of life.
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
Most maternal deaths are averted with basic healthcare, but war destroys healthcare networks. Rights groups note that fear is now driving women away from facilities once considered safe, leading them to risky home births devoid of emergency care.
“When childbirth centers become intentional targets points toward a broader and more sinister pattern: the use of violence against hospitals as a tool for terror and to break societal cohesion,” notes a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”