🔗 Share this article

Thirty women were huddled for safety in a maternity hospital in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, while others were actively in labor.

Present at the hospital after dark, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “The sounds of screaming reached me of women and children,” he explains. “They executed everybody inside the hospital. Survival meant running for your life.”

This appalling incident stands as among the worst examples in the protracted internal conflict tearing the African nation apart. Armed soldiers raided the hospital, leaving dead more than 460 innocent people inside.

Rights organizations have labeled it “an unspeakable atrocity,” and a stark illustration of the deteriorating protection for civilians trapped in war-torn areas in several nations at war.

A Record of Violence On Childbirth Services

Despite every significant nation are signatories to the international laws of war, which obligate them to protect civilians, the past year has seen a record number of assaults against medical infrastructure. Expectant mothers are highly exposed due to their need for locally available medical care.

Data analysis and investigations show an unprecedented scale of attacks: nearly 300 violent acts against places and people associated with childbirth over the last three years, including at least 119 bombardments of hospitals and delivery wards.

“These are not inevitable outcomes of conflict. They form a systematic assault on childbirth.”

The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where a vast number of expectant mothers are stranded.

Mothers have lost their lives, blocked from reaching help, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 abducted, and 101 detained—sometimes while assisting births.

A Worldwide Emergency in Maternal Health

The numbers are probably a grave undercount, as they only include incidents documented publicly. In many areas of fighting, information is scarce.

Last year, findings indicated that 50% of women who died during pregnancy or childbirth lived amidst hostilities. This underscores a devastating pattern.

In addition to the loss of life, these attacks are destroying maternal and neonatal care facilities, posing a long-term threat to community survival.

Conditions within Gaza

In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as a factor in declaring certain actions a genocide.

Following truces, doctors report that women and children are still perishing from a lack of proper treatment, owing to critical shortages of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals were inaccessible.

“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 rejected 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. Reports from frontline hospitals describe births occurring in shelters and skyrocketing stress leading to maternal health issues.

“The attacks on us are intentional,” claims 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 faces the threat of assault,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”

A Culture of Impunity

For the over half a billion females living close to deadly warfare, there are minimal protections and rare trials for atrocities for those targeting maternity care.

This void of justice has fostered a “atmosphere of lawlessness,” says a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, may constitute 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 communication blackout 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

A large proportion of mother deaths are avoidable with standard medicine, 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 devoid of emergency care.

“When childbirth centers become intentional targets points toward a wider and more disturbing trend: 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 may forfeit their immunity if used for acts deemed ‘prejudicial to the opposing side’, which has increasingly been used as a justification.”