Dozens of women were huddled for safety in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Among them were new mothers, while others were experiencing childbirth.
Present at the hospital after dark, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “The sounds of screaming reached me 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 protracted internal conflict tearing the North African nation apart. Combatants stormed the facility, reportedly killing more than 460 patients and their companions.
Rights organizations have described it as “an unspeakable atrocity,” and a prime example of the vanishing safeguards for civilians trapped in war-torn areas in multiple global hotspots.
An Unprecedented Assault Against Maternal Care
Despite every significant nation are signatories to the Geneva conventions, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Mothers in labor are particularly at risk due to their reliance on locally available medical care.
An investigation of records uncover an shocking trend: nearly 300 attacks on and disruptions to places and people associated with childbirth over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“This is not standard wartime hazards. They represent a systematic assault on childbirth.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where countless of expectant mothers are stranded.
Mothers have lost their lives, prevented from accessing care, or forced to give birth in dangerous and unsanitary conditions. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 abducted, and 101 detained—sometimes during medical procedures.
The Global Crisis for Mothers and Newborns
These figures likely represent a grave undercount, as they only include incidents documented publicly. In many war-torn areas, communications are sparse.
Last year, it was reported that 50% of women who lost their lives in maternal circumstances lived amidst hostilities. This underscores a catastrophic reality.
Apart from fatalities, these attacks are wrecking hospitals and wards, creating a grave danger to community survival.
The Situation in Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as one reason behind declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children are still perishing from medical shortages, owing to critical shortages of medicine and equipment. Agencies have reported women having children by the roadside because hospitals could not be reached.
“We’ve had rockets targeting the wards, operating rooms, and maternity wards,” says 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 struck and ruined in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and extreme psychological pressure leading to birth complications.
“Russia is targeting us deliberately,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The truth of the matter is, every facility can be under attack now,” states a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris can strike a hospital.”
Accountability Evaporates
For the over half a billion females living within range of fighting, there are scarce guarantees and a stark lack of legal accountability for those attacking childbirth services.
This void of justice has fostered a “atmosphere of lawlessness,” says a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, are potentially acts of genocide by preventing births.”
Additional Hotspots
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 communication blackout from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, resulting in tragic loss of life.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have faced detention, death, or harm over the past two years of civil war.
The End of Safe Deliveries
A large proportion of mother 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 without skilled assistance.
“When childbirth centers become intentional targets speaks to a wider and more disturbing trend: the use of attacks on medical facilities as a weapon to spread fear and to break societal cohesion,” observes a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has increasingly been used as a justification.”
