🔗 Share this article

Dozens of women were huddled for safety in a childbirth facility in El Fasher, Sudan, as the slaughter began. Among them were new mothers, while others were in the midst of labor.

On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “The sounds of screaming reached me of women and children,” he explains. “They were killing everyone inside the hospital. Survival meant running for your life.”

This appalling incident stands as one of the most shocking examples in the protracted internal conflict tearing the African nation apart. Armed soldiers forced their way into the building, leaving dead more than 460 individuals receiving care and their families.

Rights organizations have called it “an act of unspeakable brutality,” and a prime example of the collapse in safety for civilians living amidst warfare in multiple global hotspots.

An Unprecedented Assault Against Maternal Care

While all major powers are signatories to the international laws of war, which commit them to defending civilians, the past year has seen a record number of attacks on healthcare systems. Women undergoing childbirth are highly exposed due to their need for locally available medical care.

An investigation of records reveal an alarming level of violence: 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 pattern of reproductive violence.”

The majority of these attacks have taken place in regions embroiled in intense conflict, where hundreds of thousands of expectant mothers are stranded.

Women have been killed, prevented from accessing care, or made to have their babies in perilous and unsafe environments. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 taken hostage, and 101 detained—sometimes while assisting births.

A Worldwide Emergency for Mothers and Newborns

The numbers are probably a grave undercount, as they are limited to incidents documented publicly. In many areas of fighting, information is scarce.

Last year, it was reported that 50% of women who lost their lives in maternal circumstances were in a conflict area. This underscores a catastrophic reality.

Apart from fatalities, these attacks are obliterating hospitals and wards, jeopardizing the future to societal repopulation and recovery.

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.

Despite periods of calm, doctors report that women and children succumb from medical shortages, owing to severe deficits of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals could not be reached.

“We’ve had rockets targeting 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 attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births taking place in basements 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.

“In fact, 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 near active conflicts, there are scarce guarantees and rare trials for atrocities for those assaulting reproductive health.

This lack of accountability has led to a “culture of impunity,” explains a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by hindering reproduction.”

Additional Hotspots

In El Fasher, the area was isolated 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 inability to report from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, 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 End of Safe Deliveries

A large proportion of mother deaths are avoidable with standard medicine, but war shatters health systems. Rights groups note that anxiety is forcing 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 broader and more sinister pattern: the use of violence against hospitals as a means of intimidation and to destroy community bonds,” notes 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 ‘harmful to the enemy’, which has increasingly been used as a justification.”