Thirty women were seeking shelter in a childbirth facility in El Fasher, Sudan, as the slaughter began. Some had just delivered their newborns, while others were experiencing childbirth.
Present at the hospital after dark, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “The sounds of screaming reached me of women and children,” he recounts. “They executed everybody inside the hospital. Those who could run, fled.”
This appalling incident stands as among the worst examples in the protracted internal conflict tearing the African nation apart. Militiamen stormed the facility, leaving dead more than 460 individuals receiving care and their families.
Rights organizations have described it as “an unspeakable atrocity,” and a clear case of the vanishing safeguards for civilians caught in conflict zones in multiple global hotspots.
An Unprecedented Assault Against Maternal Care
Although world powers are signatories to the Geneva conventions, which commit them to defending civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Women undergoing childbirth are exceptionally vulnerable due to their reliance on locally available medical care.
Data analysis and investigations reveal an shocking trend: nearly 300 incidents targeting or hindering 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 natural consequences of war. They constitute a deliberate strategy of violence against reproduction.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where countless of pregnant women are trapped.
Mothers have lost their lives, denied medical attention, or compelled to deliver in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 abducted, and 101 arrested—sometimes in the act of delivering babies.
A Worldwide Emergency for Mothers and Newborns
Statistics are thought to be a substantial underreporting, as they only include incidents documented publicly. In many war-torn areas, reporting is limited.
Last year, it was reported that 50% of women who perished while pregnant or giving birth lived amidst hostilities. This underscores a catastrophic reality.
Apart from fatalities, these attacks are wrecking hospitals and wards, creating a grave danger to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as part of the basis for genocide allegations.
Following truces, doctors report that women and children are still perishing from a lack of proper treatment, owing to desperate lacks of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals were inaccessible.
“We’ve had rockets fired at 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 seeking to affect birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 childbirth centers have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births forced underground and skyrocketing stress 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 faces the threat of assault,” comments a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
A Culture of Impunity
For the hundreds of millions of women living close to deadly warfare, there are scarce guarantees and even fewer war crimes prosecutions for those assaulting reproductive health.
This void of justice has led to a “culture of impunity,” argues a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, can be understood as acts of genocide by destroying a group's future.”
Additional Hotspots
In El Fasher, the area lacked access to 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 damaged a maternity hospital, resulting in tragic loss of life.
In Myanmar, clinics have been attacked and dozens of midwives and patients have suffered violence over the past two years of civil war.
The End of Safe Deliveries
A large proportion of mother 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 larger and alarming strategy: the use of violence against hospitals as a means of intimidation and to tear apart the social fabric,” observes a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘prejudicial to the opposing side’, which has increasingly been used as a justification.”
