A group of thirty mothers had taken refuge 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, a technician named Abdo-Rabo Ahmed, became one of the few known survivors. “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 brutal attack stands as a particularly egregious examples in the ongoing war tearing the North African nation apart. Combatants forced their way into the building, reportedly killing more than 460 patients and their companions.
Rights organizations have called it “an act of unspeakable brutality,” and a prime example of the vanishing safeguards for civilians living amidst warfare in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault Against Maternal Care
Although world powers have agreed to the international laws of war, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Expectant mothers are exceptionally vulnerable due to their need for locally available medical care.
Research and compiled data show an alarming level of violence: 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.
“This is not inevitable outcomes of conflict. They constitute a systematic assault on childbirth.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where countless of women bearing children are confined.
Women have been killed, denied medical attention, or compelled to deliver in dangerous and unsanitary conditions. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 kidnapped, and 101 arrested—sometimes in the act of delivering babies.
The Global Crisis in Maternal Health
Statistics are thought to be a grave undercount, as they only include incidents documented publicly. In many war-torn areas, communications are sparse.
Last year, it was reported that one in two mothers who lost their lives in maternal circumstances resided in a war zone. This underscores a horrifying trend.
Apart from fatalities, these attacks are obliterating maternal and neonatal care facilities, jeopardizing the future to demographic stability.
Conditions within Gaza
In Gaza, the ruinous consequences 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 desperate lacks of medicine and equipment. Agencies have reported women having children by the roadside because hospitals could not be reached.
“We’ve had rockets 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 seeking to affect birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 hospitals for mothers and babies have been damaged or destroyed in Ukraine. Reports from frontline hospitals describe births forced underground and skyrocketing stress leading to maternal health issues.
“Russia is targeting us deliberately,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“The reality is, every facility can be under attack now,” comments 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 near active conflicts, there are few safeguards and a stark lack of legal accountability for those attacking childbirth services.
This absence of consequences has created a “culture of impunity,” argues 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 rising sharply, 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 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
Most maternal deaths are averted with basic healthcare, but war shatters health systems. Rights groups note that fear is now driving women away from facilities once considered safe, leading them to risky home births without skilled assistance.
“If maternity hospitals are being deliberately targeted indicates a larger and alarming strategy: the use of violence against hospitals as a means of intimidation 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 can lose their protected status if used for acts deemed ‘militarily advantageous’, which has often been cited as an excuse.”
