Dozens of women 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 in the midst of labor.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “I heard the screams of women and children,” he states. “They were killing everyone inside the hospital. We who were able to escape, did so.”
This brutal attack stands as among the worst examples in the ongoing war tearing the African nation apart. Militiamen raided the hospital, reportedly killing more than 460 individuals receiving care and their families.
Rights organizations have labeled it “an unspeakable atrocity,” and a stark illustration of the vanishing safeguards for civilians caught in conflict zones in multiple global hotspots.
An Unprecedented Assault Against Maternal Care
Although world powers have agreed to the international laws of war, which commit them to defending civilians, the past year has experienced a historic high of violence targeting health services. Expectant mothers are particularly at risk due to their reliance on locally available medical care.
Research and compiled data show an unprecedented scale of attacks: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“These are not inevitable outcomes of conflict. They constitute a systematic assault on childbirth.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where countless of expectant mothers are stranded.
Mothers have lost their lives, blocked from reaching help, or compelled to deliver in dangerous and unsanitary conditions. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 kidnapped, and 101 arrested—sometimes in the act of delivering babies.
The Global Crisis for Mothers and Newborns
Statistics are thought to be a significant underestimate, as they only include incidents reported in news outlets. In many war-torn areas, communications are sparse.
Last year, it was reported that half of all women who died during pregnancy or childbirth lived amidst hostilities. This underscores a horrifying trend.
In addition to the loss of life, these attacks are wrecking hospitals and wards, creating a grave danger to community survival.
The Situation in Gaza
In Gaza, the ruinous consequences on reproductive health rights has been cited by a UN commission as one reason behind genocide allegations.
Despite periods of calm, doctors report that women and children are still perishing from inadequate care, owing to severe deficits of medicine and equipment. UN officials have relayed women having children by the roadside because hospitals were out of reach.
“Our facility has endured missile strikes fired at the wards, operating rooms, and maternity wards,” explains 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 maternity and neonatal facilities have been damaged or destroyed in Ukraine. Accounts from embattled medical centers describe births forced underground and skyrocketing stress leading to problems during delivery.
“The attacks on us are intentional,” 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,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”
Accountability Evaporates
For the over half a billion females living near active conflicts, there are scarce guarantees and a stark lack of legal accountability for those assaulting reproductive health.
This lack of accountability has created a “environment where anything goes,” argues a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, may constitute acts of genocide by hindering reproduction.”
Additional Hotspots
In El Fasher, the area lacked access to humanitarian aid long before the hospital attack, with malnutrition rising sharply, 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 struck a baby care unit, 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 avoidable with standard medicine, but war collapses medical infrastructure. Rights groups note that anxiety is forcing women away from facilities once considered safe, resulting in risky home births lacking professional help.
“The deliberate attack on maternity wards indicates a wider and more disturbing trend: the use of attacks on medical facilities as a tool for terror 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 ‘militarily advantageous’, which has often been cited as an excuse.”
