🔗 Share this article

Dozens of women were huddled for safety in a maternity hospital in El Fasher, Sudan, when the massacre started. Among them were new mothers, while others were actively in labor.

On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “I heard the screams of women and children,” he states. “They were killing everyone inside the hospital. We who were able to escape, did so.”

This brutal attack stands as a particularly egregious examples in the two-year civil war tearing the African nation apart. Militiamen raided the hospital, leaving dead more than 460 patients and their companions.

Rights organizations have labeled it “an unspeakable atrocity,” and a stark illustration of the collapse in safety for civilians trapped in war-torn areas in several nations at war.

A Record of Violence On Childbirth Services

While all major powers have agreed to the Geneva conventions, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Women undergoing childbirth are particularly at risk due to their need for locally available medical care.

Data analysis and investigations 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 bombardments of hospitals and delivery wards.

“These are not natural consequences of war. They represent a systematic assault on childbirth.”

The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where countless of expectant mothers are stranded.

Deaths have occurred, denied medical attention, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been killed, 15 abducted, and 101 arrested—sometimes while assisting births.

The Global Crisis in Maternal Health

Statistics are thought to be a significant underestimate, as they capture solely incidents reported in news outlets. In many war-torn areas, reporting is limited.

Last year, findings indicated that 50% of women who lost their lives in maternal circumstances were in a conflict area. This underscores a devastating pattern.

Apart from fatalities, these attacks are destroying critical infrastructure for mothers and babies, posing a long-term threat to societal repopulation and recovery.

The Situation in Gaza

In Gaza, the ruinous consequences on reproductive health rights has been cited by a UN commission as a factor in genocide allegations.

Even after ceasefires, doctors report that women and children succumb from a lack of proper treatment, owing to critical shortages of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals were inaccessible.

“Direct shelling targeting the wards, operating rooms, and maternity wards,” says 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 hospitals for mothers and babies have been damaged or destroyed in Ukraine. Journalism from conflict zones describe births forced underground 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 reality is, every facility is now a potential target,” comments a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris can strike a hospital.”

Accountability Evaporates

For the more than 676 million women living close to deadly warfare, there are minimal protections and a stark lack of legal accountability for those attacking childbirth services.

This void of justice has fostered a “culture of impunity,” says a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, can be understood as acts of genocide by destroying a group's future.”

Additional Hotspots

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 scarce because of a communication blackout from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, resulting in tragic loss of life.

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 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 without skilled assistance.

“The deliberate attack on maternity wards indicates a broader and more sinister pattern: the use of attacks on medical facilities as a tool for terror 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.”