Thirty women had taken refuge in a childbirth facility in El Fasher, Sudan, when the massacre started. Several had recently given birth, while others were actively in labor.
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. “The sounds of screaming reached me of women and children,” he states. “A massacre was taking place 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. Militiamen raided the hospital, leaving dead more than 460 patients and their companions.
Rights organizations have labeled it “an act of unspeakable brutality,” and a prime example of the deteriorating protection for civilians living amidst warfare in several nations at war.
An Unprecedented Assault Against Maternal Care
Despite every significant nation are signatories to the Geneva conventions, which commit them to defending civilians, the past year has seen a record number of violence targeting health services. Women undergoing childbirth are highly exposed due to their dependence on locally available medical care.
Research and compiled data uncover 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 targeted attacks against hospitals and delivery wards.
“These are not inevitable outcomes of conflict. They constitute a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where hundreds of thousands of pregnant women are trapped.
Mothers have lost their lives, prevented from accessing care, or made to have their babies in dangerous and unsanitary conditions. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 abducted, and 101 arrested—sometimes during medical procedures.
A Worldwide Emergency for Mothers and Newborns
Statistics are thought to be a substantial underreporting, as they only include incidents covered by the media. In many war-torn areas, communications are sparse.
Last year, analysis showed that half of all women who perished while pregnant or giving birth lived amidst hostilities. This underscores a catastrophic reality.
Apart from fatalities, these attacks are wrecking critical infrastructure for mothers and babies, jeopardizing the future to societal repopulation and recovery.
The Situation in Gaza
In Gaza, the catastrophic impact on reproductive health rights has been cited by a UN commission as one reason behind declaring certain actions a genocide.
Despite periods of calm, doctors report that women and children continue to die from medical shortages, owing to desperate lacks of medicine and equipment. Agencies have reported women delivering babies amidst ruins because hospitals were inaccessible.
“Direct shelling 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 hospitals for mothers and babies have been attacked and rendered unusable in Ukraine. Reports from frontline hospitals describe births forced underground and extreme psychological pressure leading to maternal health issues.
“Russia is targeting us deliberately,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“In fact, every facility can be under attack now,” notes a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris can strike a hospital.”
A Culture of Impunity
For the over half a billion females living within range of fighting, there are few safeguards and even fewer war crimes prosecutions for those attacking childbirth services.
This absence of consequences has created 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 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 limited by a inability to report from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, 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 Collapse of Safe Childbirth
Most maternal deaths are avoidable with standard medicine, but war destroys healthcare networks. Rights groups note that anxiety is forcing women away from facilities once considered safe, pushing them toward risky home births without skilled assistance.
“If maternity hospitals are being deliberately targeted points toward a wider and more disturbing trend: the use of violence against hospitals as a weapon to spread fear and to break societal cohesion,” notes a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘harmful to the enemy’, which has now become a standard defence.”
