Dozens of women were huddled for safety in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Several had recently given birth, while others were experiencing childbirth.
On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, became one of the few known survivors. “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 appalling incident stands as a particularly egregious examples in the ongoing war tearing the African nation apart. Armed soldiers stormed the facility, leaving dead more than 460 individuals receiving care and their families.
Rights organizations have labeled it “an unspeakable atrocity,” and a stark illustration of the vanishing safeguards for civilians caught in conflict zones in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence Against Maternal Care
While all major powers are signatories to the international laws of war, which obligate them to protect civilians, the past year has seen a record number of violence targeting health services. Mothers in labor are highly exposed due to their need for locally available medical care.
Data analysis and investigations show an shocking trend: nearly 300 attacks on and disruptions to maternity care facilities, staff, and pregnant women over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“This is not natural consequences of war. They form a pattern of reproductive violence.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where countless of women bearing children are confined.
Deaths have occurred, denied medical attention, 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 abducted, and 101 arrested—sometimes in the act of delivering babies.
A Worldwide Emergency for Mothers and Newborns
Statistics are thought to be a substantial underreporting, as they capture solely incidents documented publicly. In many war-torn areas, reporting is limited.
Last year, analysis showed 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 wrecking hospitals and wards, creating a grave danger to community survival.
The Situation in Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as a factor in declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children continue to die from a lack of proper treatment, owing to desperate lacks of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals could not be reached.
“Our facility has endured missile strikes fired at the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or trying to alter birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births taking place in basements and skyrocketing stress leading to birth complications.
“We are being singled out,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The reality is, every facility can be under attack now,” comments a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
A Culture of Impunity
For the more than 676 million women living close to deadly warfare, there are minimal protections and rare trials for atrocities for those targeting maternity care.
This lack of accountability has fostered a “atmosphere of lawlessness,” says a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, are potentially acts of genocide by hindering reproduction.”
Other Conflict Zones
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 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 been arrested, killed, or injured over the past two years of civil war.
The Collapse of Safe Childbirth
Most maternal deaths are averted with basic healthcare, but war shatters health systems. Rights groups note that anxiety is forcing women away from facilities once considered safe, resulting in risky home births lacking professional help.
“The deliberate attack on maternity wards speaks to a wider and more disturbing trend: the use of attacks on medical facilities as a weapon to spread fear and to tear apart the social fabric,” says a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘harmful to the enemy’, which has increasingly been used as a justification.”
