Dozens of women had taken refuge in a childbirth facility in El Fasher, Sudan, as the slaughter began. Among them were new mothers, while others were experiencing childbirth.
On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “The sounds of screaming reached me of women and children,” he recounts. “A massacre was taking place inside the hospital. We who were able to escape, did so.”
This horrifying event stands as a particularly egregious examples in the two-year civil war tearing the North African nation apart. Combatants stormed the facility, reportedly killing more than 460 innocent people inside.
Rights organizations have called it “an unspeakable atrocity,” and a prime example of the collapse in safety for civilians living amidst warfare in multiple global hotspots.
An Unprecedented Assault Against Maternal Care
Despite every significant nation have signed the international laws of war, which require them to safeguard civilians, the past year has seen a record number of attacks on healthcare systems. Women undergoing childbirth are exceptionally vulnerable due to their need for locally available medical care.
An investigation of records show an alarming level of violence: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These are not natural consequences of war. They form a systematic assault on childbirth.”
The majority of these incidents have happened in regions embroiled in intense conflict, where a vast number of women bearing children are confined.
Women have been killed, 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 slain, 15 abducted, and 101 detained—sometimes while assisting births.
The Global Crisis for Mothers and Newborns
Statistics are thought to be a significant underestimate, as they capture solely incidents covered by the media. In many war-torn areas, reporting is limited.
Last year, it was reported that one in two mothers who lost their lives in maternal circumstances were in a conflict area. This underscores a catastrophic reality.
Apart from fatalities, these attacks are wrecking hospitals and wards, creating a grave danger to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as a factor in declaring certain actions a genocide.
Following truces, doctors report that women and children continue to die from inadequate care, owing to critical shortages of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals were out of reach.
“We’ve had rockets targeting the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or seeking to affect birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 childbirth centers have been attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births forced underground and extreme psychological pressure leading to maternal health issues.
“Russia is targeting us deliberately,” asserts 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 can be under attack now,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris could impact a hospital.”
A Culture of Impunity
For the more than 676 million women living near active conflicts, there are minimal protections and a stark lack of legal accountability for those attacking childbirth services.
This void of justice has led to a “culture of impunity,” argues a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, may constitute acts of genocide by preventing births.”
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 restricted due to a inability to report from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, resulting in tragic loss of life.
In Myanmar, clinics have been attacked 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 avoidable with standard medicine, but war shatters health systems. Rights groups note that fear is now driving women away from facilities once considered safe, resulting in risky home births without skilled assistance.
“When childbirth centers become intentional targets indicates a larger and alarming strategy: the use of attacks on medical facilities as a means of intimidation and to destroy community bonds,” says a legal researcher.
“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has often been cited as an excuse.”
