A group of thirty mothers had taken refuge in a maternity hospital in El Fasher, Sudan, as the slaughter began. Among them were new mothers, while others were actively in labor.
Working that night, a 28-year-old lab technician, a technician named 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. Survival meant running for your life.”
This horrifying event stands as a particularly egregious examples in the two-year civil war tearing the African nation apart. Armed soldiers forced their way into the building, allegedly slaughtering more than 460 patients and their companions.
Rights organizations have described it as “an unspeakable atrocity,” and a clear case of the vanishing safeguards for civilians trapped in war-torn areas 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 seen a record number of assaults against medical infrastructure. Expectant mothers are highly exposed due to their reliance on locally available medical care.
Data analysis and investigations reveal an unprecedented scale of attacks: nearly 300 violent acts against maternity care facilities, staff, and pregnant women 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 constitute a pattern of reproductive violence.”
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 deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 kidnapped, and 101 taken into custody—sometimes while assisting births.
A Worldwide Emergency in Maternal Health
The numbers are probably a grave undercount, as they are limited to incidents documented publicly. In many areas of fighting, communications are sparse.
Last year, it was reported that 50% of women who lost their lives in maternal circumstances were in a conflict area. This underscores a catastrophic reality.
In addition to the loss of life, these attacks are obliterating hospitals and wards, jeopardizing the future to community survival.
Conditions within Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as one reason behind accusations of genocidal acts.
Even after ceasefires, doctors report that women and children succumb from inadequate care, owing to severe deficits of medicine and equipment. Agencies have reported women having children by the roadside because hospitals were inaccessible.
“We’ve had rockets fired at 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 aiming to influence birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 childbirth centers have been struck and ruined in Ukraine. Journalism from conflict zones describe births occurring in shelters and skyrocketing stress leading to maternal health issues.
“The attacks on us are intentional,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The reality is, every facility can be under attack now,” comments a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris could impact a hospital.”
A Culture of Impunity
For the over half a billion females living near active conflicts, there are few safeguards and even fewer war crimes prosecutions for those assaulting reproductive health.
This absence of consequences has created a “culture of impunity,” explains a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, are potentially acts of genocide by hindering reproduction.”
Other Conflict Zones
In El Fasher, the area lacked access to humanitarian aid long before the hospital attack, with malnutrition rising sharply, 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 struck a baby care unit, resulting in tragic loss of life.
In Myanmar, clinics have been attacked and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The End of Safe Deliveries
A large proportion of mother deaths are averted with basic healthcare, but war shatters health systems. 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 indicates a broader and more sinister pattern: the use of attacks on medical facilities as a means of intimidation and to destroy community bonds,” observes 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 ‘harmful to the enemy’, which has often been cited as an excuse.”
