Thirty women were seeking shelter in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Some had just delivered their newborns, while others were experiencing childbirth.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “There were cries of women and children,” he explains. “They executed everybody inside the hospital. We who were able to escape, did so.”
This appalling incident stands as one of the most shocking examples in the two-year civil war tearing the North African nation apart. Combatants forced their way into the building, leaving dead more than 460 patients and their companions.
Rights organizations have labeled it “a crime beyond words,” and a stark illustration of the vanishing safeguards for civilians trapped in war-torn areas in multiple global hotspots.
A Record of Violence Against Maternal Care
While all major powers have agreed to the international laws of war, which commit them to defending civilians, the past year has witnessed an unprecedented spike of assaults against medical infrastructure. Women undergoing childbirth are exceptionally vulnerable due to their dependence on locally available medical care.
Data analysis and investigations show an unprecedented scale of attacks: nearly 300 attacks on and disruptions to 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 natural consequences of war. They constitute a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where a vast number of women bearing children are confined.
Women have been killed, blocked from reaching help, or compelled to deliver in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 abducted, and 101 detained—sometimes during medical procedures.
A Worldwide Emergency for Mothers and Newborns
Statistics are thought to be a grave undercount, as they only include incidents reported in news outlets. In many conflict zones, information is scarce.
Last year, analysis showed that half of all women who died during pregnancy or childbirth lived amidst hostilities. This underscores a catastrophic reality.
In addition to the loss of life, these attacks are wrecking hospitals and wards, jeopardizing the future to community survival.
The Situation in Gaza
In Gaza, the ruinous consequences on reproductive health rights has been cited by a UN commission as part of the basis for genocide allegations.
Even after ceasefires, doctors report that women and children continue to die from medical shortages, owing to critical shortages of medicine and equipment. Agencies have reported women delivering babies amidst ruins because hospitals could not be reached.
“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 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 forced underground and extreme psychological pressure leading to problems during delivery.
“The attacks on us are intentional,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“In fact, every facility can be under attack now,” states a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”
Accountability Evaporates
For the hundreds of millions of women living close to deadly warfare, there are few safeguards and rare trials for atrocities for those assaulting reproductive health.
This lack of accountability has led to a “atmosphere of lawlessness,” says a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by hindering reproduction.”
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 hit a neonatal ward, 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
The majority of childbirth fatalities are preventable with routine care, but war collapses medical infrastructure. Rights groups note that terror is compelling women away from facilities once considered safe, leading them to risky home births lacking professional help.
“If maternity hospitals are being deliberately targeted indicates a broader and more sinister pattern: the use of attacks on medical facilities as a means of intimidation and to destroy community bonds,” notes a legal researcher.
“Hospitals are not completely safe 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.”
