A group of thirty mothers were seeking shelter in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Among them were new mothers, while others were actively in labor.
On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “There were cries of women and children,” he states. “A massacre was taking place inside the hospital. Those who could run, fled.”
This appalling incident stands as among the worst examples in the ongoing war tearing the North African nation apart. Armed soldiers stormed the facility, allegedly slaughtering more than 460 innocent people inside.
Rights organizations have described it as “an unspeakable atrocity,” and a prime example of the vanishing safeguards for civilians living amidst warfare in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence Against Maternal Care
Despite every significant nation have agreed to the Geneva conventions, which commit them to defending civilians, the past year has seen a record number of violence targeting health services. Women undergoing childbirth are exceptionally vulnerable due to their need for locally available medical care.
An investigation of records reveal an shocking trend: nearly 300 attacks on and disruptions to maternity care facilities, staff, and pregnant women over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“These are not inevitable outcomes of conflict. They form a pattern of reproductive violence.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where countless of women bearing children are confined.
Women have been killed, prevented from accessing care, or forced to give birth in deplorable situations. The data also indicates that at least 68 maternal health workers have been slain, 15 taken hostage, and 101 taken into custody—sometimes in the act of delivering babies.
A Worldwide Emergency in Maternal Health
Statistics are thought to be a grave undercount, as they are limited to incidents documented publicly. In many areas of fighting, information is scarce.
Last year, findings indicated that 50% of women who died during pregnancy or childbirth lived amidst hostilities. This underscores a devastating pattern.
In addition to the loss of life, these attacks are wrecking hospitals and wards, jeopardizing the future 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 declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children succumb from medical shortages, owing to severe deficits of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals were inaccessible.
“We’ve had rockets fired at the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or aiming to influence birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities have been damaged or destroyed in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and extreme psychological pressure leading to problems during delivery.
“The attacks on us are intentional,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“In fact, every facility faces the threat of assault,” states a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris can strike a hospital.”
Accountability Evaporates
For the more than 676 million women living within range of fighting, there are scarce guarantees and even fewer war crimes prosecutions for those attacking childbirth services.
This void of justice has fostered a “culture of impunity,” argues a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, can be understood as acts of genocide by hindering reproduction.”
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 limited by a communication blackout from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, resulting in tragic loss of life.
In Myanmar, hospitals have come under fire 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
A large proportion of mother deaths are avoidable with standard medicine, 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.
“When childbirth centers become intentional targets speaks to a broader and more sinister pattern: the use of attacks on medical facilities as a tool for terror and to break societal cohesion,” says a legal researcher.
“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘harmful to the enemy’, which has now become a standard defence.”
