Thirty women were seeking shelter in a maternity hospital in El Fasher, Sudan, as the slaughter began. Several had recently given birth, while others were experiencing childbirth.
On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “I heard the screams of women and children,” he explains. “They executed everybody inside the hospital. Those who could run, fled.”
This appalling incident stands as one of the most shocking examples in the ongoing war tearing the African nation apart. Combatants forced their way into the building, leaving dead more than 460 individuals receiving care and their families.
Rights organizations have described it as “an act of unspeakable brutality,” and a stark illustration of the deteriorating protection for civilians living amidst warfare in several nations at war.
An Unprecedented Assault On Childbirth Services
Although world powers have signed the international laws of war, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of attacks on healthcare systems. Women undergoing childbirth are exceptionally vulnerable due to their dependence on locally available medical care.
An investigation of records show 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 standard wartime hazards. They form a deliberate strategy of violence against reproduction.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where a vast number of pregnant women are trapped.
Women have been killed, denied medical attention, or made to have their babies in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 abducted, and 101 taken into custody—sometimes during medical procedures.
A Worldwide Emergency for Mothers and Newborns
Statistics are thought to be a significant underestimate, as they capture solely incidents documented publicly. In many areas of fighting, reporting is limited.
Last year, findings indicated that half of all women who perished while pregnant or giving birth resided in a war zone. This underscores a catastrophic reality.
Beyond killing women and staff, these attacks are wrecking critical infrastructure for mothers and babies, posing a long-term threat to community survival.
Conditions within Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as part of the basis for declaring certain actions a genocide.
Following truces, doctors report that women and children continue to die from medical shortages, owing to desperate lacks of medicine and equipment. Agencies have reported women delivering babies amidst ruins because hospitals were out of reach.
“Our facility has endured missile strikes targeting the wards, operating rooms, and maternity wards,” says 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 maternity and neonatal facilities have been struck and ruined in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and extreme psychological pressure leading to problems during delivery.
“Russia is targeting us deliberately,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The truth of the matter is, every facility can be under attack now,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
Accountability Evaporates
For the more than 676 million women living within range of fighting, there are minimal protections and rare trials for atrocities for those assaulting reproductive health.
This lack of accountability has created a “environment where anything goes,” explains a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, may constitute acts of genocide by hindering reproduction.”
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 inability to report from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, resulting in tragic loss of life.
In Myanmar, hospitals have come under fire 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
Most maternal deaths 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 without skilled assistance.
“If maternity hospitals are being deliberately targeted speaks to a wider and more disturbing trend: the use of attacks on medical facilities as a means of intimidation and to break societal cohesion,” says a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘militarily advantageous’, which has increasingly been used as a justification.”
