A group of thirty mothers 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 experiencing childbirth.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “The sounds of screaming reached me of women and children,” he explains. “A massacre was taking place inside the hospital. Survival meant running for your life.”
This horrifying event stands as among the worst examples in the ongoing war tearing the North African nation apart. Militiamen raided the hospital, allegedly slaughtering more than 460 individuals receiving care and their families.
Rights organizations have called it “a crime beyond words,” and a stark illustration of the deteriorating protection for civilians caught in conflict zones in several nations at war.
An Unprecedented Assault On Childbirth Services
Despite every significant nation have agreed to the international laws of war, which obligate them to protect civilians, the past year has seen a record number of assaults against medical infrastructure. Expectant mothers are particularly at risk due to their need for locally available medical care.
Research and compiled data show an shocking trend: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These are not standard wartime hazards. They constitute a systematic assault on childbirth.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where hundreds of thousands of expectant mothers are stranded.
Women have been killed, blocked from reaching help, or compelled to deliver in deplorable situations. The data also indicates that at least 68 maternal health workers have been murdered, 15 abducted, and 101 taken into custody—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
The numbers are probably a substantial underreporting, as they are limited to incidents documented publicly. In many areas of fighting, communications are sparse.
Last year, it was reported that one in two mothers who perished while pregnant or giving birth were in a conflict area. This underscores a horrifying trend.
Apart from fatalities, these attacks are obliterating maternal and neonatal care facilities, posing a long-term threat to community survival.
The Situation in Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as part of the basis for genocide allegations.
Following truces, doctors report that women and children continue to die from a lack of proper treatment, owing to critical shortages of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals could not be reached.
“Direct shelling hitting the wards, operating rooms, and maternity wards,” explains 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. Accounts from embattled medical centers describe births taking place in basements 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 reality is, every facility can be under attack now,” states a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
A Culture of Impunity
For the hundreds of millions of women living within range of fighting, there are scarce guarantees and a stark lack of legal accountability for those attacking childbirth services.
This lack of accountability has created a “environment where anything goes,” argues a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, are potentially acts of genocide by hindering reproduction.”
Additional Hotspots
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 restricted due to a inability to report from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, killing mothers, babies, and nurses.
In Myanmar, hospitals have come under fire and dozens of midwives and patients have suffered violence over the past two years of civil war.
The Collapse of Safe Childbirth
A large proportion of mother deaths are averted with basic healthcare, but war destroys healthcare networks. Rights groups note that fear is now driving women away from facilities once considered safe, resulting in risky home births devoid of emergency care.
“If maternity hospitals are being deliberately targeted points toward a larger and alarming strategy: the use of attacks on medical facilities as a tool for terror and to tear apart the social fabric,” notes a legal researcher.
“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘harmful to the enemy’, which has now become a standard defence.”
