Thirty women had taken refuge in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Among them were new mothers, while others were in the midst of labor.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “There were cries of women and children,” he explains. “A massacre was taking place inside the hospital. Those who could run, fled.”
This appalling incident stands as among the worst examples in the ongoing war tearing the African nation apart. Militiamen raided the hospital, allegedly slaughtering more than 460 patients and their companions.
Rights organizations have called it “a crime beyond words,” and a stark illustration of the vanishing safeguards for civilians trapped in war-torn areas in several nations at war.
A Record of Violence On Childbirth Services
Although world powers have agreed to the Geneva conventions, which require them to safeguard civilians, the past year has seen a record number of assaults against medical infrastructure. Expectant mothers are exceptionally vulnerable due to their need for locally available medical care.
An investigation of records uncover an unprecedented scale of attacks: nearly 300 violent acts against places and people associated with childbirth 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 deliberate strategy of violence against reproduction.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where hundreds of thousands of expectant mothers are stranded.
Mothers have lost their lives, denied medical attention, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been killed, 15 abducted, and 101 taken into custody—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 areas of fighting, communications are sparse.
Last year, analysis showed that half of all women who perished while pregnant or giving birth resided in a war zone. This underscores a horrifying trend.
In addition to the loss of life, 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 reproductive health rights 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 are still perishing from a lack of proper treatment, owing to critical shortages of medicine and equipment. Accounts describe women delivering babies amidst ruins 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 denied deliberately targeting maternity care or aiming to influence birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 childbirth centers have been damaged or destroyed in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and extreme psychological pressure leading to birth complications.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“In fact, every facility can be under attack now,” states a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”
A Culture of Impunity
For the hundreds of millions of women living close to deadly warfare, there are few safeguards and a stark lack of legal accountability for those assaulting reproductive health.
This absence of consequences has fostered a “atmosphere of lawlessness,” explains a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, can be understood as acts of genocide by preventing births.”
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 scarce because of a inability to report from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, resulting in tragic loss of life.
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 Collapse of Safe Childbirth
A large proportion of mother deaths are preventable with routine care, but war destroys healthcare networks. 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 points toward a wider and more disturbing trend: the use of violence against hospitals as a tool for terror and to tear apart the social fabric,” notes a legal researcher.
“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”
