Dozens of women were seeking shelter in a childbirth facility in El Fasher, Sudan, as the slaughter began. Among them were new mothers, while others were actively in labor.
On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “There were cries of women and children,” he states. “They executed everybody inside the hospital. Survival meant running for your life.”
This horrifying event stands as among the worst examples in the two-year civil war tearing the North African nation apart. Militiamen raided the hospital, reportedly killing more than 460 innocent people inside.
Rights organizations have called it “an unspeakable atrocity,” and a prime example of the vanishing safeguards for civilians living amidst warfare in multiple global hotspots.
An Unprecedented Assault Against Maternal Care
Despite every significant nation have agreed to the international laws of war, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Women undergoing childbirth are particularly at risk due to their dependence on locally available medical care.
An investigation of records uncover an shocking trend: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“This is not inevitable outcomes of conflict. They represent a systematic assault on childbirth.”
The majority of these attacks have taken place in regions embroiled in intense conflict, 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 maternal health workers have been slain, 15 abducted, and 101 arrested—sometimes in the act of delivering babies.
A Worldwide Emergency for Mothers and Newborns
The numbers are probably a grave undercount, as they only include incidents reported in news outlets. In many conflict zones, information is scarce.
Last year, analysis showed that 50% of women who lost their lives in maternal circumstances resided in a war zone. This underscores a catastrophic reality.
In addition to the loss of life, these attacks are obliterating maternal and neonatal care facilities, jeopardizing the future to community survival.
The Situation in Gaza
In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as a factor in accusations of genocidal acts.
Despite periods of calm, doctors report that women and children succumb from medical shortages, owing to desperate lacks of medicine and equipment. UN officials have relayed women having children by the roadside because hospitals were inaccessible.
“Our facility has endured missile strikes fired at the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has denied 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 damaged or destroyed in Ukraine. Accounts from embattled medical centers describe births forced underground and extreme psychological pressure leading to maternal health issues.
“The attacks on us are intentional,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“The reality is, every facility is now a potential target,” states a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
Accountability Evaporates
For the over half a billion females living close to deadly warfare, there are few safeguards and rare trials for atrocities for those targeting maternity care.
This void of justice has fostered a “culture of impunity,” says a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, can be understood as 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 spiking dangerously, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is limited by a communication blackout from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, causing fatalities among patients and staff.
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
A large proportion of mother deaths are averted with basic healthcare, but war destroys healthcare networks. Rights groups note that terror is compelling women away from facilities once considered safe, pushing them toward risky home births devoid of emergency care.
“When childbirth centers become intentional targets indicates a wider and more disturbing trend: the use of violence against hospitals as a tool for terror and to break societal cohesion,” observes 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 often been cited as an excuse.”