A group of thirty mothers had taken refuge in a childbirth facility in El Fasher, Sudan, as the slaughter began. 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, became one of the few known survivors. “The sounds of screaming reached me of women and children,” he states. “They executed everybody inside the hospital. Those who could run, fled.”
This horrifying event stands as among the worst examples in the ongoing war tearing the African nation apart. Armed soldiers stormed the facility, leaving dead more than 460 innocent people inside.
Rights organizations have labeled it “an unspeakable atrocity,” and a prime example of the vanishing safeguards for civilians caught in conflict zones in multiple global hotspots.
An Unprecedented Assault On Childbirth Services
While all major powers have agreed to the Geneva conventions, which require them to safeguard civilians, the past year has seen a record number of assaults against medical infrastructure. Women undergoing childbirth are highly exposed due to their reliance on locally available medical care.
An investigation of records show 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 direct strikes on hospitals and delivery wards.
“These are not standard wartime hazards. They represent a systematic assault on childbirth.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where countless of pregnant women are trapped.
Deaths have occurred, blocked from reaching help, or made to have their babies in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been murdered, 15 kidnapped, and 101 arrested—sometimes while assisting births.
The Global Crisis in Maternal Health
The numbers are probably a substantial underreporting, as they capture solely incidents reported in news outlets. In many areas of fighting, reporting is limited.
Last year, analysis showed that one in two mothers who died during pregnancy or childbirth lived amidst hostilities. This underscores a devastating pattern.
Apart from fatalities, these attacks are destroying hospitals and wards, creating a grave danger to societal repopulation and recovery.
The Situation in Gaza
In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as a factor in declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children succumb from a lack of proper treatment, owing to critical shortages of medicine and equipment. Accounts describe women having children by the roadside because hospitals were inaccessible.
“Our facility has endured missile strikes 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.
Ukraine's Ordeal
Since early 2022, at least 80 childbirth centers have been struck and ruined in Ukraine. Journalism from conflict zones describe births taking place in basements and extreme psychological pressure leading to maternal health issues.
“Russia is targeting us deliberately,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“The reality is, every facility is now a potential target,” states 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 over half a billion females living close to deadly warfare, there are few safeguards and rare trials for atrocities for those attacking childbirth services.
This void of justice has created a “environment where anything goes,” argues a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, are potentially 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 lack of access from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, 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
Most maternal deaths are avoidable with standard medicine, but war destroys healthcare networks. Rights groups note that fear is now driving women away from facilities once considered safe, resulting in risky home births lacking professional help.
“The deliberate attack on maternity wards speaks to a broader and more sinister pattern: the use of violence against hospitals as a means of intimidation and to break societal cohesion,” notes 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 ‘harmful to the enemy’, which has now become a standard defence.”
