Dozens of women were huddled for safety 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, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “There were cries of women and children,” he recounts. “They were killing everyone inside the hospital. We who were able to escape, did so.”
This horrifying event stands as among the worst examples in the two-year civil war tearing the North African nation apart. Armed soldiers forced their way into the building, allegedly slaughtering more than 460 innocent people inside.
Rights organizations have described it as “an act of unspeakable brutality,” and a clear case of the vanishing safeguards for civilians caught in conflict zones in several nations at war.
An Unprecedented Assault On Childbirth Services
Although world powers are signatories to the Geneva conventions, which commit them to defending civilians, the past year has seen a record number of assaults against medical infrastructure. Women undergoing childbirth are exceptionally vulnerable due to their need for locally available medical care.
Research and compiled data show 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 incidents do not represent inevitable outcomes of conflict. They represent a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where countless of pregnant women are trapped.
Women have been killed, denied medical attention, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been slain, 15 abducted, and 101 arrested—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
The numbers are probably a significant underestimate, as they only include incidents covered by the media. In many war-torn areas, information is scarce.
Last year, analysis showed that one in two mothers who lost their lives in maternal circumstances lived amidst hostilities. This underscores a catastrophic reality.
Apart from fatalities, these attacks are obliterating hospitals and wards, creating a grave danger to societal repopulation and recovery.
The Situation in Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as one reason behind declaring certain actions a genocide.
Despite periods of calm, doctors report that women and children are still perishing from inadequate care, owing to desperate lacks of medicine and equipment. Accounts describe women giving birth in rubble because hospitals were out of reach.
“We’ve had rockets hitting the wards, operating rooms, and maternity wards,” states 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 childbirth centers have been attacked and rendered unusable in Ukraine. Reports from frontline hospitals describe births occurring in shelters and skyrocketing stress leading to birth complications.
“Russia is targeting us deliberately,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The truth of the matter is, every facility can be under attack now,” notes a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris could impact a hospital.”
Accountability Evaporates
For the over half a billion females living close to deadly warfare, there are few safeguards and even fewer war crimes prosecutions for those attacking childbirth services.
This lack of accountability has led to a “culture of impunity,” explains a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, 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 rising sharply, 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, causing fatalities among patients and staff.
In Myanmar, hospitals have come under fire 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 collapses medical infrastructure. 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 speaks to a broader and more sinister pattern: the use of attacks on medical facilities as a means of intimidation and to break societal cohesion,” observes 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 ‘harmful to the enemy’, which has now become a standard defence.”
