Thirty women were seeking shelter in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. Some had just delivered their newborns, while others were experiencing childbirth.
Present at the hospital after dark, 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 explains. “They were killing everyone inside the hospital. Those who could run, fled.”
This brutal attack stands as among the worst examples in the two-year civil war tearing the African nation apart. Armed soldiers forced their way into the building, leaving dead more than 460 patients and their companions.
Rights organizations have called it “an unspeakable atrocity,” and a prime example of the deteriorating protection for civilians trapped in war-torn areas in several nations at war.
An Unprecedented Assault On Childbirth Services
Although world powers have signed the Geneva conventions, which obligate them to protect civilians, the past year has seen a record number of violence targeting health services. Expectant mothers are exceptionally vulnerable due to their dependence on locally available medical care.
Data analysis and investigations show an shocking trend: nearly 300 incidents targeting or hindering maternity care facilities, staff, and pregnant women over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“This is not inevitable outcomes of conflict. They form a pattern of reproductive violence.”
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, denied medical attention, or compelled to deliver in dangerous and unsanitary conditions. The data also indicates that at least 68 maternal health workers have been murdered, 15 taken hostage, and 101 arrested—sometimes in the act of delivering babies.
A Worldwide Emergency for Mothers and Newborns
Statistics are thought to be a significant underestimate, as they only include incidents reported in news outlets. In many conflict zones, communications are sparse.
Last year, findings indicated that 50% of women who died during pregnancy or childbirth resided in a war zone. This underscores a horrifying trend.
Beyond killing women and staff, these attacks are wrecking critical infrastructure for mothers and babies, creating a grave danger to demographic stability.
Conditions within Gaza
In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as part of the basis for genocide allegations.
Following truces, doctors report that women and children are still perishing from a lack of proper treatment, owing to severe deficits of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals could not be reached.
“Direct shelling fired at 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.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been struck and ruined in Ukraine. Reports from frontline hospitals describe births occurring in shelters and extreme psychological pressure leading to birth complications.
“The attacks on us are intentional,” claims 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,” comments a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris can strike a hospital.”
Accountability Evaporates
For the hundreds of millions of women living within range of fighting, there are minimal protections and rare trials for atrocities for those assaulting reproductive health.
This absence of consequences has fostered a “environment where anything goes,” explains a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, can be understood as acts of genocide by hindering reproduction.”
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 limited by 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 End of Safe Deliveries
The majority of childbirth fatalities are avoidable with standard medicine, but war shatters health systems. Rights groups note that terror is compelling women away from facilities once considered safe, resulting in risky home births devoid of emergency care.
“When childbirth centers become intentional targets points toward a broader and more sinister pattern: the use of violence against hospitals as a weapon to spread fear and to tear apart the social fabric,” says a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”
