A group of thirty mothers were huddled for safety in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Some had just delivered their newborns, while others were experiencing childbirth.
Present at the hospital after dark, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “I heard the screams of women and children,” he explains. “They executed everybody inside the hospital. Survival meant running for your life.”
This appalling incident stands as a particularly egregious examples in the two-year civil war tearing the African nation apart. Armed soldiers stormed the facility, leaving dead more than 460 innocent people inside.
Rights organizations have called it “an act of unspeakable brutality,” and a stark illustration of the collapse in safety for civilians living amidst warfare in multiple global hotspots.
A Record of Violence Against Maternal Care
While all major powers are signatories to the Geneva conventions, which obligate them to protect civilians, the past year has seen a record number of violence targeting health services. Expectant mothers are particularly at risk due to their need for locally available medical care.
Data analysis and investigations show 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 direct strikes on hospitals and delivery wards.
“These are not natural consequences of war. They form a deliberate strategy of violence against reproduction.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where a vast number of women bearing children are confined.
Deaths have occurred, prevented from accessing care, or forced to give birth in deplorable situations. The data also indicates that at least 68 maternal health workers have been murdered, 15 taken hostage, and 101 taken into custody—sometimes while assisting births.
The Global Crisis for Mothers and Newborns
Statistics are thought to be a significant underestimate, as they only include incidents reported in news outlets. In many war-torn areas, information is scarce.
Last year, it was reported that one in two mothers who perished while pregnant or giving birth resided in a war zone. This underscores a horrifying trend.
In addition to the loss of life, these attacks are wrecking critical infrastructure for mothers and babies, creating a grave danger to societal repopulation and recovery.
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 succumb from medical shortages, owing to desperate lacks of medicine and equipment. Accounts describe women having children by the roadside because hospitals could not be reached.
“Our facility has endured missile strikes 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.
Ukraine's Ordeal
Since early 2022, at least 80 hospitals for mothers and babies have been attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births taking place in basements and skyrocketing stress leading to problems during delivery.
“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 reality is, every facility is now a potential target,” states a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”
A Culture of Impunity
For the hundreds of millions of women living near active conflicts, there are minimal protections and a stark lack of legal accountability for those assaulting reproductive health.
This absence of consequences has fostered a “culture of impunity,” says a human rights lawyer. “Attacks on reproductive healthcare, 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 lacked access to humanitarian aid long before the hospital attack, with malnutrition spiking dangerously, 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 hit a neonatal ward, resulting in tragic loss of life.
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 End of Safe Deliveries
A large proportion of mother deaths are preventable with routine care, but war destroys healthcare networks. Rights groups note that terror is compelling women away from facilities once considered safe, resulting in risky home births devoid of emergency care.
“When childbirth centers become intentional targets speaks to a wider and more disturbing trend: the use of violence against hospitals as a weapon to spread fear and to tear apart the social fabric,” observes a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”
