Dozens of women had taken refuge in a maternity hospital in El Fasher, Sudan, as the slaughter began. Among them were new mothers, while others were in the midst of labor.
Present at the hospital after dark, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “The sounds of screaming reached me of women and children,” he explains. “A massacre was taking place inside the hospital. We who were able to escape, did so.”
This appalling incident stands as a particularly egregious examples in the ongoing war tearing the North African nation apart. Militiamen raided the hospital, leaving dead more than 460 innocent people inside.
Rights organizations have described it as “a crime beyond words,” and a prime example of the vanishing safeguards for civilians caught in conflict zones in several nations at war.
A Record of Violence On Childbirth Services
Despite every significant nation have signed the Geneva conventions, which obligate them to protect civilians, the past year has seen a record number of assaults against medical infrastructure. Expectant mothers are highly exposed due to their dependence on locally available medical care.
An investigation of records reveal 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 targeted attacks against hospitals and delivery wards.
“These incidents do not represent inevitable outcomes of conflict. They constitute a deliberate strategy of violence against reproduction.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where a vast number of women bearing children are confined.
Mothers have lost their lives, prevented from accessing care, or compelled to deliver in dangerous and unsanitary conditions. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 kidnapped, and 101 arrested—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
The numbers are probably a substantial underreporting, as they capture solely incidents reported in news outlets. In many conflict zones, communications are sparse.
Last year, it was reported that half of all women who lost their lives in maternal circumstances lived amidst hostilities. This underscores a devastating pattern.
Apart from fatalities, these attacks are obliterating hospitals and wards, posing a long-term threat to demographic stability.
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 succumb from medical shortages, owing to severe deficits of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals were out of reach.
“Direct shelling fired at the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or trying to alter birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 hospitals for mothers and babies have been damaged or destroyed in Ukraine. Reports from frontline hospitals describe births occurring in shelters and skyrocketing stress leading to maternal health issues.
“Russia is targeting us deliberately,” 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,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”
Accountability Evaporates
For the over half a billion females living within range of fighting, there are scarce guarantees and even fewer war crimes prosecutions for those assaulting reproductive health.
This absence of consequences has led to a “atmosphere of lawlessness,” explains a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, may constitute 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 spiking dangerously, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is scarce because of a lack of access 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 been arrested, killed, or injured over the past two years of civil war.
The End of Safe Deliveries
The majority of childbirth fatalities are preventable with routine care, but war collapses medical infrastructure. Rights groups note that fear is now driving women away from facilities once considered safe, leading them to risky home births lacking professional help.
“If maternity hospitals are being deliberately targeted speaks to a wider and more disturbing trend: the use of violence against hospitals as a tool for terror and to destroy community bonds,” notes a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘prejudicial to the opposing side’, which has often been cited as an excuse.”
