Dozens of women were huddled for safety in a maternity hospital in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, while others were actively in labor.
On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “The sounds of screaming reached me of women and children,” he recounts. “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 ongoing war tearing the North African nation apart. Combatants forced their way into the building, allegedly slaughtering more than 460 patients and their companions.
Rights organizations have called it “an unspeakable atrocity,” and a stark illustration of the collapse in safety for civilians living amidst warfare in multiple global hotspots.
A Record of Violence On Childbirth Services
Although world powers have agreed to the international laws of war, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Expectant mothers are exceptionally vulnerable due to their need for locally available medical care.
An investigation of records reveal an alarming level of violence: nearly 300 violent acts against places and people associated with childbirth over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“This is not inevitable outcomes of conflict. They represent a pattern of reproductive violence.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where a vast number of pregnant women are trapped.
Mothers have lost their lives, denied medical attention, or compelled to deliver in deplorable situations. 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 for Mothers and Newborns
The numbers are probably a substantial underreporting, as they are limited to incidents reported in news outlets. In many war-torn areas, communications are sparse.
Last year, findings indicated that half of all women who died during pregnancy or childbirth resided in a war zone. This underscores a devastating pattern.
In addition to the loss of life, these attacks are obliterating critical infrastructure for mothers and babies, jeopardizing the future to community survival.
The Situation in Gaza
In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as part of the basis for accusations of genocidal acts.
Following truces, doctors report that women and children continue to die from medical shortages, owing to severe deficits of medicine and equipment. Agencies have reported women having children by the roadside 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.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been struck and ruined in Ukraine. Journalism from conflict zones describe births occurring in shelters and skyrocketing stress leading to maternal health issues.
“We are being singled out,” asserts 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,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
Accountability Evaporates
For the more than 676 million women living near active conflicts, there are minimal protections and a stark lack of legal accountability for those attacking childbirth services.
This void of justice has created a “environment where anything goes,” argues a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, 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 restricted due to a communication blackout from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, resulting in tragic loss of life.
In Myanmar, hospitals have come under fire and dozens of midwives and patients have faced detention, death, or harm over the past two years of civil war.
The Collapse of Safe Childbirth
The majority of childbirth fatalities are averted with basic healthcare, but war shatters health systems. Rights groups note that fear is now driving women away from facilities once considered safe, leading them to risky home births lacking professional help.
“When childbirth centers become intentional targets speaks to a larger and alarming strategy: the use of violence against hospitals as a tool for terror and to tear apart the social fabric,” notes a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘militarily advantageous’, which has increasingly been used as a justification.”
