A group of thirty mothers had taken refuge 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.
On duty during that fateful night, 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 explains. “They executed everybody inside the hospital. We who were able to escape, did so.”
This horrifying event stands as among the worst examples in the ongoing war tearing the North African nation apart. Armed soldiers raided the hospital, leaving dead more than 460 innocent people inside.
Rights organizations have described it as “an act of unspeakable brutality,” and a prime example of the vanishing safeguards for civilians trapped in war-torn areas in several nations at war.
An Unprecedented Assault Against Maternal Care
Despite every significant nation have agreed to the Geneva conventions, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of assaults against medical infrastructure. Mothers in labor are particularly at risk due to their dependence on locally available medical care.
Data analysis and investigations uncover an shocking trend: nearly 300 violent acts against places and people associated with childbirth over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“This is not inevitable outcomes of conflict. They represent 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.
Mothers have lost their lives, blocked from reaching help, or made to have their babies in dangerous and unsanitary conditions. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 abducted, and 101 detained—sometimes in the act of delivering babies.
The Global Crisis in Maternal Health
Statistics are thought to be a grave undercount, as they are limited to incidents covered by the media. In many areas of fighting, communications are sparse.
Last year, analysis showed that one in two mothers who perished while pregnant or giving birth lived amidst hostilities. This underscores a horrifying trend.
In addition to the loss of life, these attacks are destroying critical infrastructure for mothers and babies, creating a grave danger to demographic stability.
Conditions within Gaza
In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as one reason behind accusations of genocidal acts.
Even after ceasefires, doctors report that women and children continue to die from inadequate care, owing to critical shortages of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals were out of reach.
“Direct shelling hitting the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or aiming to influence birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births forced underground and skyrocketing stress leading to problems during delivery.
“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. “Even if air defence intercepts a drone, the falling debris may hit a hospital.”
A Culture of Impunity
For the over half a billion females living within range of fighting, there are minimal protections and even fewer war crimes prosecutions for those attacking childbirth services.
This absence of consequences has fostered a “environment where anything goes,” explains a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, may constitute acts of genocide by destroying a group's future.”
Other Conflict Zones
In El Fasher, the area had been cut off from 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 scarce because of a communication blackout from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, killing mothers, babies, and nurses.
In Myanmar, clinics have been attacked and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The Collapse of Safe Childbirth
Most maternal deaths are preventable with routine care, but war collapses medical infrastructure. Rights groups note that fear is now driving women away from facilities once considered safe, leading them to risky home births lacking professional help.
“The deliberate attack on maternity wards indicates a wider and more disturbing trend: the use of attacks on medical facilities as a means of intimidation and to destroy community bonds,” observes a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘harmful to the enemy’, which has often been cited as an excuse.”