Dozens of women were huddled for safety in a maternity hospital in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, while others were in the midst of labor.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “There were cries of women and children,” he states. “They were killing everyone inside the hospital. We who were able to escape, did so.”
This brutal attack stands as among the worst examples in the ongoing war tearing the African nation apart. Combatants raided the hospital, leaving dead more than 460 patients and their companions.
Rights organizations have labeled it “an unspeakable atrocity,” and a stark illustration of the collapse in safety for civilians living amidst warfare in several nations at war.
A Record of Violence On Childbirth Services
Despite every significant nation have agreed to the international laws of war, which obligate them to protect civilians, the past year has experienced a historic high of assaults against medical infrastructure. Expectant mothers are exceptionally vulnerable due to their reliance on locally available medical care.
Research and compiled data uncover an shocking trend: 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 pattern of reproductive violence.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where a vast number of women bearing children are confined.
Mothers have lost their lives, prevented from accessing care, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 abducted, and 101 taken into custody—sometimes while assisting births.
The Global Crisis for Mothers and Newborns
Statistics are thought to be a significant underestimate, as they are limited to incidents documented publicly. In many war-torn areas, communications are sparse.
Last year, analysis showed that half of all women who died during pregnancy or childbirth were in a conflict area. This underscores a catastrophic reality.
In addition to the loss of life, these attacks are obliterating hospitals and wards, 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 accusations of genocidal acts.
Following truces, doctors report that women and children continue to die from inadequate care, owing to desperate lacks of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals were inaccessible.
“Our facility has endured missile strikes hitting the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or aiming to influence birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been damaged or destroyed in Ukraine. Journalism from conflict zones describe births occurring in shelters and extreme psychological pressure leading to birth complications.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“In fact, every facility is now a potential target,” notes a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris may hit a hospital.”
A Culture of Impunity
For the more than 676 million women living close to deadly warfare, there are scarce guarantees and a stark lack of legal accountability for those targeting maternity care.
This lack of accountability has fostered a “culture of impunity,” argues a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, are potentially acts of genocide by hindering reproduction.”
Other Conflict Zones
In El Fasher, the area had been cut off from 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 restricted due to a lack of access from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, causing fatalities among patients and staff.
In Myanmar, clinics have been attacked and dozens of midwives and patients have suffered violence 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 collapses medical infrastructure. Rights groups note that terror is compelling women away from facilities once considered safe, leading them to risky home births devoid of emergency care.
“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 destroy community bonds,” says 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 ‘prejudicial to the opposing side’, which has often been cited as an excuse.”
