A group of thirty mothers were seeking shelter in a childbirth facility in El Fasher, Sudan, when the massacre started. Among them were new mothers, while others were in the midst of labor.
On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “I heard the screams of women and children,” he explains. “They executed everybody inside the hospital. We who were able to escape, did so.”
This appalling incident stands as a particularly egregious examples in the ongoing war tearing the North African nation apart. Militiamen stormed the facility, allegedly slaughtering more than 460 innocent people inside.
Rights organizations have called it “an unspeakable atrocity,” and a clear case of the vanishing safeguards for civilians living amidst warfare in several nations at war.
An Unprecedented Assault Against Maternal Care
Despite every significant nation are signatories to the international laws of war, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Mothers in labor are particularly at risk due to their reliance on locally available medical care.
Research and compiled data uncover an unprecedented scale of attacks: nearly 300 incidents targeting or hindering places and people associated with childbirth over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“These are not inevitable outcomes of conflict. They represent a deliberate strategy of violence against reproduction.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where a vast number of women bearing children are confined.
Mothers have lost their lives, denied medical attention, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been killed, 15 abducted, and 101 arrested—sometimes while assisting births.
The Global Crisis in Maternal Health
Statistics are thought to be a substantial underreporting, as they only include incidents covered by the media. In many conflict zones, communications are sparse.
Last year, findings indicated that 50% of women who lost their lives in maternal circumstances were in a conflict area. 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 societal repopulation and recovery.
The Situation in Gaza
In Gaza, the catastrophic impact on reproductive health rights has been cited by a UN commission as one reason behind accusations of genocidal acts.
Despite periods of calm, 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 delivering babies amidst ruins because hospitals were inaccessible.
“Direct shelling hitting the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or aiming to influence birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 childbirth centers have been damaged or destroyed in Ukraine. Reports from frontline hospitals describe births occurring in shelters 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. Russian authorities have denied deliberately targeting civilians.
“In fact, every facility can be under attack now,” notes a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris can strike a hospital.”
Accountability Evaporates
For the over half a billion females living near active conflicts, there are minimal protections and a stark lack of legal accountability for those assaulting reproductive health.
This lack of accountability has fostered a “atmosphere of lawlessness,” argues a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, are potentially acts of genocide by preventing births.”
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 scarce because of a lack of access from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, killing mothers, babies, and nurses.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have been arrested, killed, or injured 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 destroys healthcare networks. Rights groups note that anxiety is forcing women away from facilities once considered safe, resulting in risky home births lacking professional help.
“If maternity hospitals are being deliberately targeted points toward a larger and alarming strategy: the use of violence against hospitals as a means of intimidation and to break societal cohesion,” says a legal researcher.
“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘harmful to the enemy’, which has often been cited as an excuse.”
