Dozens of women were huddled for safety in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. Among them were new mothers, while others were in the midst of labor.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “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 two-year civil war tearing the North African nation apart. Armed soldiers stormed the facility, reportedly killing more than 460 patients and their companions.
Rights organizations have labeled it “an act of unspeakable brutality,” and a stark illustration of the deteriorating protection for civilians trapped in war-torn areas in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault On Childbirth Services
Although world powers have agreed 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 uncover an alarming level of violence: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“These incidents do not represent standard wartime hazards. They form a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where countless of expectant mothers are stranded.
Mothers have lost their lives, prevented from accessing care, or forced to give birth in deplorable situations. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 kidnapped, 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 only include incidents reported in news outlets. In many war-torn areas, reporting is limited.
Last year, findings indicated that 50% of women who perished while pregnant or giving birth lived amidst hostilities. This underscores a horrifying trend.
In addition to the loss of life, these attacks are obliterating maternal and neonatal care facilities, creating a grave danger to demographic stability.
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 genocide allegations.
Following truces, doctors report that women and children succumb from medical shortages, owing to critical shortages of medicine and equipment. UN officials have relayed women having children by the roadside because hospitals were inaccessible.
“Our facility has endured missile strikes 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 aiming to influence birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 childbirth centers have been attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births occurring in shelters and extreme psychological pressure leading to problems during delivery.
“The attacks on us are intentional,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The truth of the matter is, every facility faces the threat of assault,” states 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 close to deadly warfare, there are minimal protections and rare trials for atrocities for those targeting maternity care.
This absence of consequences has created a “culture of impunity,” argues a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by preventing births.”
Other Conflict Zones
In El Fasher, the area was isolated 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 lack of access 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 End of Safe Deliveries
A large proportion of mother deaths are preventable with routine care, but war shatters health systems. Rights groups note that anxiety is forcing women away from facilities once considered safe, resulting in risky home births devoid of emergency care.
“If maternity hospitals are being deliberately targeted indicates a larger and alarming strategy: the use of attacks on medical facilities 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 are not inviolable if used for acts deemed ‘militarily advantageous’, which has increasingly been used as a justification.”
