Thirty women were seeking shelter in a maternity hospital in El Fasher, Sudan, when the massacre started. Among them were new mothers, while others were experiencing childbirth.
Present at the hospital after dark, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “There were cries of women and children,” he recounts. “A massacre was taking place inside the hospital. We who were able to escape, did so.”
This horrifying event stands as one of the most shocking examples in the two-year civil war tearing the North African nation apart. Combatants raided the hospital, reportedly killing more than 460 innocent people inside.
Rights organizations have described it as “a crime beyond words,” and a stark illustration of the collapse in safety for civilians living amidst warfare in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault On Childbirth Services
Despite every significant nation are signatories to the Geneva conventions, 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 reliance on locally available medical care.
Research and compiled data reveal an shocking trend: 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.
“These are not natural consequences of war. They form a pattern of reproductive violence.”
The majority of these incidents have happened in regions embroiled in intense conflict, where countless of women bearing children are confined.
Deaths have occurred, prevented from accessing care, or compelled to deliver in dangerous and unsanitary conditions. The data also indicates that at least 68 maternal health workers have been slain, 15 taken hostage, and 101 taken into custody—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
The numbers are probably a significant underestimate, as they only include incidents covered by the media. In many conflict zones, information is scarce.
Last year, findings indicated that one in two mothers who lost their lives in maternal circumstances resided in a war zone. This underscores a devastating pattern.
Beyond killing women and staff, these attacks are destroying critical infrastructure for mothers and babies, creating a grave danger to demographic stability.
The Situation in Gaza
In Gaza, the catastrophic impact on reproductive health rights has been cited by a UN commission as part of the basis for genocide allegations.
Despite periods of calm, doctors report that women and children are still perishing from a lack of proper treatment, owing to severe deficits of medicine and equipment. Agencies have reported women delivering babies amidst ruins because hospitals were out of reach.
“Our facility has endured missile strikes targeting 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 aiming to influence birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 childbirth centers have been damaged or destroyed in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and skyrocketing stress leading to maternal health issues.
“We are being singled out,” says 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 is now a potential target,” comments a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris could impact a hospital.”
Accountability Evaporates
For the hundreds of millions of women living within range of fighting, there are few safeguards and rare trials for atrocities for those attacking childbirth services.
This void of justice has fostered a “culture of impunity,” explains a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by hindering reproduction.”
Other Conflict Zones
In El Fasher, the area had been cut off 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 struck a baby care unit, causing fatalities among patients and staff.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have suffered violence over the past two years of civil war.
The End of Safe Deliveries
Most maternal deaths are averted with basic healthcare, 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.
“The deliberate attack on maternity wards speaks to a broader and more sinister pattern: the use of violence against hospitals as a means of intimidation and to break societal cohesion,” observes a legal researcher.
“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has often been cited as an excuse.”
