A group of thirty mothers had taken refuge in a childbirth facility in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, while others were experiencing childbirth.
Present at the hospital after dark, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “I heard the screams of women and children,” he recounts. “A massacre was taking place inside the hospital. Those who could run, fled.”
This appalling incident stands as one of the most shocking examples in the protracted internal conflict tearing the North African nation apart. Armed soldiers forced their way into the building, reportedly killing more than 460 patients and their companions.
Rights organizations have called it “an act of unspeakable brutality,” and a stark illustration of the vanishing safeguards for civilians living amidst warfare in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault Against Maternal Care
Despite every significant nation are signatories to the Geneva conventions, which require them to safeguard civilians, the past year has experienced a historic high of violence targeting health services. Women undergoing childbirth are particularly at risk due to their reliance on locally available medical care.
An investigation of records show an shocking trend: nearly 300 violent acts against places and people associated with childbirth over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“This is not standard wartime hazards. They form a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where countless of women bearing children are confined.
Women have been killed, prevented from accessing care, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 kidnapped, and 101 taken into custody—sometimes during medical procedures.
The Global Crisis for Mothers and Newborns
These figures likely represent a grave undercount, as they capture solely incidents reported in news outlets. In many war-torn areas, reporting is limited.
Last year, analysis showed that one in two mothers who lost their lives in maternal circumstances lived amidst hostilities. This underscores a devastating pattern.
Apart from fatalities, these attacks are wrecking maternal and neonatal care facilities, jeopardizing the future to demographic stability.
Conditions within Gaza
In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as one reason behind declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children are still perishing from a lack of proper treatment, owing to severe deficits of medicine and equipment. UN officials have relayed women having children by the roadside because hospitals could not be reached.
“Direct shelling fired at 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 trying to alter birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been attacked and rendered unusable in Ukraine. Reports from frontline hospitals describe births occurring in shelters and extreme psychological pressure leading to birth complications.
“The attacks on us are intentional,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“In fact, every facility faces the threat of assault,” 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 close to deadly warfare, there are scarce guarantees and a stark lack of legal accountability for those attacking childbirth services.
This void of justice has created a “atmosphere of lawlessness,” argues a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, may constitute acts of genocide by hindering reproduction.”
Other Conflict Zones
In El Fasher, the area had been cut off from 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 communication blackout from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, causing fatalities among patients and staff.
In Myanmar, medical facilities have been bombed 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 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.
“The deliberate attack on maternity wards points toward a wider and more disturbing trend: the use of violence against hospitals as a weapon to spread fear and to break societal cohesion,” notes a legal researcher.
“There is no absolute protection 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.”
