A group of thirty mothers were seeking shelter in a childbirth facility in El Fasher, Sudan, as the slaughter began. Among them were new mothers, while others were in the midst of labor.
Present at the hospital after dark, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “The sounds of screaming reached me of women and children,” he explains. “They were killing everyone inside the hospital. Survival meant running for your life.”
This appalling incident stands as one of the most shocking examples in the two-year civil war tearing the African nation apart. Militiamen forced their way into the building, allegedly slaughtering more than 460 innocent people inside.
Rights organizations have labeled it “an unspeakable atrocity,” and a prime example of the collapse in safety for civilians trapped in war-torn areas in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault On Childbirth Services
While all major powers have agreed to the Geneva conventions, which commit them to defending civilians, the past year has experienced a historic high of assaults against medical infrastructure. Mothers in labor are highly exposed due to their need for locally available medical care.
An investigation of records reveal an unprecedented scale of attacks: nearly 300 violent acts against places and people associated with childbirth over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These incidents do not represent natural consequences of war. They constitute a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where a vast number of women bearing children are confined.
Women have been killed, 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 slain, 15 kidnapped, and 101 arrested—sometimes in the act of delivering babies.
A Worldwide Emergency for Mothers and Newborns
These figures likely represent a substantial underreporting, as they only include incidents documented publicly. In many war-torn areas, reporting is limited.
Last year, it was reported that one in two mothers who perished while pregnant or giving birth lived amidst hostilities. This underscores a horrifying trend.
Apart from fatalities, 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 part of the basis for accusations of genocidal acts.
Following truces, doctors report that women and children succumb from medical shortages, owing to desperate lacks of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals could not be reached.
“Direct shelling targeting the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or trying to alter birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 hospitals for mothers and babies have been damaged or destroyed in Ukraine. Reports from frontline hospitals describe births taking place in basements and extreme psychological pressure leading to problems during delivery.
“Russia is targeting us deliberately,” 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,” states a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris can strike a hospital.”
A Culture of Impunity
For the over half a billion females living near active conflicts, there are minimal protections and even fewer war crimes prosecutions for those assaulting reproductive health.
This lack of accountability has fostered 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 destroying a group's future.”
Additional Hotspots
In El Fasher, the area had been cut off from 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 scarce because of 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 faced detention, death, or harm 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 destroys healthcare networks. Rights groups note that terror is compelling women away from facilities once considered safe, leading them to risky home births without skilled assistance.
“If maternity hospitals are being deliberately targeted speaks to a wider and more disturbing trend: the use of attacks on medical facilities as a means of intimidation and to break societal cohesion,” 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.”
