Thirty women were huddled for safety in a maternity hospital in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, while others were actively in labor.
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 states. “They executed everybody inside the hospital. We who were able to escape, did so.”
This appalling incident stands as among the worst examples in the ongoing war tearing the African nation apart. Militiamen raided the hospital, leaving dead more than 460 individuals receiving care and their families.
Rights organizations have labeled it “an act of unspeakable brutality,” and a stark illustration of the collapse in safety for civilians trapped in war-torn areas in several nations at war.
An Unprecedented Assault Against Maternal Care
Despite every significant nation have agreed to the Geneva conventions, which obligate them to protect civilians, the past year has seen a record number of violence targeting health services. Women undergoing childbirth are highly exposed due to their reliance on locally available medical care.
Data analysis and investigations 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 bombardments of hospitals and delivery wards.
“This is not standard wartime hazards. They constitute a deliberate strategy of violence against reproduction.”
The majority of these incidents have happened in regions embroiled in intense conflict, where hundreds of thousands of pregnant women are trapped.
Deaths have occurred, denied medical attention, or forced to give birth in deplorable situations. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 abducted, and 101 taken into custody—sometimes in the act of delivering babies.
The Global Crisis for Mothers and Newborns
These figures likely represent a grave undercount, as they are limited to incidents documented publicly. In many conflict zones, communications are sparse.
Last year, findings indicated that 50% of women who died during pregnancy or childbirth were in a conflict area. This underscores a horrifying trend.
In addition to the loss of life, these attacks are wrecking critical infrastructure for mothers and babies, jeopardizing the future to demographic stability.
Conditions within Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as a factor in accusations of genocidal acts.
Even after ceasefires, doctors report that women and children are still perishing from medical shortages, owing to critical shortages of medicine and equipment. Accounts describe women having children by the roadside because hospitals were inaccessible.
“Direct shelling hitting the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or seeking to affect birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 hospitals for mothers and babies have been struck and ruined in Ukraine. Reports from frontline hospitals describe births occurring in shelters and skyrocketing stress leading to problems during delivery.
“We are being singled out,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“The reality is, every facility can be under attack now,” comments a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris could impact a hospital.”
A Culture of Impunity
For the hundreds of millions of women living near active conflicts, there are scarce guarantees and a stark lack of legal accountability for those targeting maternity care.
This void of justice has led to a “culture of impunity,” argues a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, may constitute acts of genocide by destroying a group's future.”
Additional Hotspots
In El Fasher, the area was isolated from 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 limited by a lack of access 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 been arrested, killed, or injured over the past two years of civil war.
The End of Safe Deliveries
The majority of childbirth fatalities are avoidable with standard medicine, but war collapses medical infrastructure. Rights groups note that terror is compelling women away from facilities once considered safe, resulting in 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 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 now become a standard defence.”
