A group of thirty mothers were seeking shelter in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. Several had recently given birth, while others were experiencing childbirth.
Present at the hospital after dark, a 28-year-old lab technician, 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. We who were able to escape, did so.”
This horrifying event stands as one of the most shocking examples in the protracted internal conflict tearing the North African nation apart. Militiamen stormed the facility, reportedly killing more than 460 innocent people inside.
Rights organizations have labeled it “a crime beyond words,” and a clear case of the deteriorating protection for civilians caught in conflict zones in several nations at war.
A Record of Violence On Childbirth Services
Despite every significant nation have agreed to the Geneva conventions, which commit them to defending civilians, the past year has experienced a historic high of attacks on healthcare systems. Women undergoing childbirth are highly exposed due to their dependence on locally available medical care.
Research and compiled data uncover an shocking trend: nearly 300 incidents targeting or hindering 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 represent a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where hundreds of thousands of expectant mothers are stranded.
Mothers have lost their lives, prevented from accessing care, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been slain, 15 abducted, and 101 taken into custody—sometimes in the act of delivering babies.
A Worldwide Emergency in Maternal Health
Statistics are thought to be a grave undercount, as they capture solely incidents reported in news outlets. In many areas of fighting, information is scarce.
Last year, analysis showed that 50% of women who died during pregnancy or childbirth resided in a war zone. This underscores a devastating pattern.
In addition to the loss of life, these attacks are obliterating hospitals and wards, posing a long-term threat to community survival.
Conditions within Gaza
In Gaza, the catastrophic impact on reproductive health rights has been cited by a UN commission as a factor in declaring certain actions a genocide.
Despite periods of calm, doctors report that women and children continue to die from inadequate care, owing to severe deficits of medicine and equipment. Agencies have reported women having children by the roadside because hospitals were out of reach.
“We’ve had rockets hitting the wards, operating rooms, and maternity wards,” says 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 attacked and rendered unusable in Ukraine. Reports from frontline hospitals describe births occurring in shelters and extreme psychological pressure leading to problems during delivery.
“We are being singled out,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“The truth of the matter is, every facility faces the threat of assault,” comments a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris could impact a hospital.”
Accountability Evaporates
For the over half a billion females living close to deadly warfare, there are scarce guarantees and even fewer war crimes prosecutions for those attacking childbirth services.
This void of justice has created a “culture of impunity,” says a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, can be understood as acts of genocide by destroying a group's future.”
Other Conflict Zones
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 communication blackout from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, resulting in tragic loss of life.
In Myanmar, hospitals have come under fire and dozens of midwives and patients have suffered violence over the past two years of civil war.
The Collapse of Safe Childbirth
The majority of childbirth fatalities are preventable with routine care, 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 speaks to a larger and alarming strategy: the use of attacks on medical facilities as a weapon to spread fear and to destroy community bonds,” observes a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘militarily advantageous’, which has often been cited as an excuse.”
