Thirty women were seeking shelter in a childbirth facility in El Fasher, Sudan, as the slaughter began. Several had recently given birth, while others were in the midst of labor.
On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “There were cries of women and children,” he states. “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 protracted internal conflict 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 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 Geneva conventions, which require them to safeguard civilians, the past year has experienced a historic high of attacks on healthcare systems. Women undergoing childbirth are highly exposed due to their reliance on locally available medical care.
Data analysis and investigations show 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.
“These are not standard wartime hazards. They form a systematic assault on childbirth.”
The majority of these incidents have happened in regions embroiled in intense conflict, where countless of women bearing children are confined.
Women have been killed, prevented from accessing care, or forced to give birth in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 kidnapped, and 101 detained—sometimes during medical procedures.
The Global Crisis for Mothers and Newborns
The numbers are probably a grave undercount, as they are limited to incidents documented publicly. In many conflict zones, communications are sparse.
Last year, it was reported that one in two mothers who perished while pregnant or giving birth were in a conflict area. This underscores a catastrophic reality.
In addition to the loss of life, these attacks are wrecking hospitals and wards, posing a long-term threat to demographic stability.
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.
Despite periods of calm, doctors report that women and children continue to die from medical shortages, owing to severe deficits of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals were inaccessible.
“Our facility has endured missile strikes hitting 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 aiming to influence birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 hospitals for mothers and babies have been struck and ruined in Ukraine. Journalism from conflict zones describe births occurring in shelters and skyrocketing stress leading to problems during delivery.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“In fact, every facility is now a potential target,” states a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris can strike a hospital.”
Accountability Evaporates
For the hundreds of millions of women living within range of fighting, there are minimal protections and rare trials for atrocities for those assaulting reproductive health.
This void of justice has led to a “environment where anything goes,” says a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, may constitute acts of genocide by preventing births.”
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, resulting in tragic loss of life.
In Myanmar, clinics have been attacked and dozens of midwives and patients have suffered violence over the past two years of civil war.
The Collapse of Safe Childbirth
Most maternal 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, pushing them toward risky home births lacking professional help.
“When childbirth centers become intentional targets indicates a broader and more sinister pattern: the use of attacks on medical facilities 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 are not inviolable if used for acts deemed ‘harmful to the enemy’, which has increasingly been used as a justification.”
