Thirty women were seeking shelter in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Among them were new mothers, while others were experiencing childbirth.
Present at the hospital after dark, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “There were cries of women and children,” he recounts. “They executed everybody inside the hospital. Survival meant running for your life.”
This horrifying event stands as a particularly egregious examples in the protracted internal conflict tearing the North African nation apart. Militiamen forced their way into the building, reportedly killing more than 460 innocent people inside.
Rights organizations have called it “a crime beyond words,” and a prime example of the deteriorating protection for civilians trapped in war-torn areas in several nations at war.
An Unprecedented Assault Against Maternal Care
Although world powers have agreed to 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 exceptionally vulnerable due to their dependence on locally available medical care.
An investigation of records reveal 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.
“These are not natural consequences of war. They represent a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where a vast number of pregnant women are trapped.
Women have been killed, denied medical attention, or made to have their babies in dangerous and unsanitary conditions. The data also indicates that at least 68 maternal health workers have been slain, 15 kidnapped, and 101 detained—sometimes while assisting births.
A Worldwide Emergency in Maternal Health
These figures likely represent a significant underestimate, as they are limited to incidents documented publicly. In many areas of fighting, communications are sparse.
Last year, analysis showed that 50% of women who perished while pregnant or giving birth were in a conflict area. This underscores a horrifying trend.
Apart from fatalities, these attacks are wrecking maternal and neonatal care facilities, jeopardizing the future to community survival.
Conditions within Gaza
In Gaza, the ruinous consequences on reproductive health rights has been cited by a UN commission as one reason behind accusations of genocidal acts.
Even after ceasefires, doctors report that women and children are still perishing from a lack of proper treatment, owing to severe deficits of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals could not be reached.
“We’ve had rockets hitting 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 childbirth centers have been struck and ruined in Ukraine. Accounts from embattled medical centers describe births taking place in basements and skyrocketing stress 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 truth of the matter is, every facility is now a potential target,” states 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 within range of fighting, there are scarce guarantees and rare trials for atrocities for those targeting maternity care.
This lack of accountability has fostered a “atmosphere of lawlessness,” argues a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, are potentially 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 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 struck a baby care unit, causing fatalities among patients and staff.
In Myanmar, clinics have been attacked and dozens of midwives and patients have faced detention, death, or harm over the past two years of civil war.
The Collapse of Safe Childbirth
The majority of childbirth fatalities are preventable with routine care, but war collapses medical infrastructure. Rights groups note that anxiety is forcing women away from facilities once considered safe, resulting in risky home births devoid of emergency care.
“If maternity hospitals are being deliberately targeted speaks to a wider and more disturbing trend: the use of violence against hospitals as a means of intimidation and to break societal cohesion,” observes a legal researcher.
“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘prejudicial to the opposing side’, which has often been cited as an excuse.”
