Thirty women were seeking shelter in a maternity hospital in El Fasher, Sudan, when the massacre started. Among them were new mothers, while others were actively in labor.
Present at the hospital after dark, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “I heard the screams of women and children,” he explains. “A massacre was taking place inside the hospital. We who were able to escape, did so.”
This horrifying event stands as among the worst examples in the protracted internal conflict tearing the North African nation apart. Armed soldiers forced their way into the building, reportedly killing more than 460 individuals receiving care and their families.
Rights organizations have described it as “a crime beyond words,” and a clear case of the deteriorating protection for civilians trapped in war-torn areas in multiple global hotspots.
An Unprecedented Assault On Childbirth Services
Despite every significant nation have agreed 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. Mothers in labor are exceptionally vulnerable due to their dependence on locally available medical care.
Data analysis and investigations reveal an unprecedented scale of attacks: nearly 300 attacks on and disruptions to 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 natural consequences of war. They constitute a deliberate strategy of violence against reproduction.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where hundreds of thousands of expectant mothers are stranded.
Mothers have lost their lives, prevented from accessing care, or compelled to deliver in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 abducted, and 101 detained—sometimes in the act of delivering babies.
The Global Crisis for Mothers and Newborns
Statistics are thought to be a substantial underreporting, as they are limited to incidents reported in news outlets. In many conflict zones, information is scarce.
Last year, findings indicated that one in two mothers who lost their lives in maternal circumstances were in a conflict area. This underscores a catastrophic reality.
Apart from fatalities, these attacks are destroying maternal and neonatal care facilities, posing a long-term threat to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the catastrophic impact on reproductive health rights has been cited by a UN commission as a factor in genocide allegations.
Despite periods of calm, doctors report that women and children succumb from inadequate care, owing to critical shortages of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals could not be reached.
“Direct shelling hitting the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or seeking to affect birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 childbirth centers have been attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births forced underground and extreme psychological pressure leading to maternal health issues.
“The attacks on us are intentional,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The truth of the matter is, every facility can be under attack now,” comments a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris can strike a hospital.”
A Culture of Impunity
For the more than 676 million women living near active conflicts, there are few safeguards and a stark lack of legal accountability for those attacking childbirth services.
This void of justice has led to a “culture of impunity,” says a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, are potentially acts of genocide by preventing births.”
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 limited by a lack of access from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, killing mothers, babies, and nurses.
In Myanmar, medical facilities have been bombed 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
The majority of childbirth fatalities are averted with basic healthcare, but war shatters health systems. Rights groups note that fear is now driving women away from facilities once considered safe, resulting in risky home births devoid of emergency care.
“When childbirth centers become intentional targets indicates a larger and alarming strategy: the use of attacks on medical facilities as a means of intimidation and to tear apart the social fabric,” observes 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 ‘militarily advantageous’, which has often been cited as an excuse.”
