Thirty women had taken refuge in a maternity hospital 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, managed to survive the ordeal. “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 a particularly egregious examples in the ongoing war tearing the North African nation apart. Armed soldiers forced their way into the building, allegedly slaughtering more than 460 individuals receiving care and their families.
Rights organizations have called it “an act of unspeakable brutality,” and a stark illustration of the collapse in safety for civilians trapped in war-torn areas in several nations at war.
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 seen a record number of attacks on healthcare systems. Women undergoing childbirth are highly exposed due to their dependence on locally available medical care.
Research and compiled data reveal 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 targeted attacks against hospitals and delivery wards.
“This is not natural consequences of war. They constitute a pattern of reproductive violence.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where countless of women bearing children are confined.
Women have been killed, blocked from reaching help, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 taken hostage, and 101 detained—sometimes in the act of delivering babies.
A Worldwide Emergency in Maternal Health
Statistics are thought to be a grave undercount, as they only include incidents reported in news outlets. In many areas of fighting, communications are sparse.
Last year, it was reported that half of all women who died during pregnancy or childbirth lived amidst hostilities. This underscores a catastrophic reality.
Apart from fatalities, these attacks are wrecking hospitals and wards, posing a long-term threat to societal repopulation and recovery.
The Situation in Gaza
In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as part of the basis for accusations of genocidal acts.
Following truces, doctors report that women and children are still perishing from inadequate care, owing to severe deficits of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals could not be reached.
“Direct shelling targeting the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has denied 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 attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births occurring in shelters and extreme psychological pressure leading to maternal health issues.
“We are being singled out,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The reality is, every facility can be under attack now,” notes a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris could impact a hospital.”
A Culture of Impunity
For the over half a billion females living close to deadly warfare, there are few safeguards and rare trials for atrocities for those targeting maternity care.
This lack of accountability has created a “environment where anything goes,” explains a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, are potentially acts of genocide by preventing births.”
Additional Hotspots
In El Fasher, the area was isolated 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 limited by a inability to report from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, 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 Collapse of Safe Childbirth
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 lacking professional help.
“The deliberate attack on maternity wards speaks to a wider and more disturbing trend: the use of attacks on medical facilities as a means of intimidation and to break societal cohesion,” 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 ‘militarily advantageous’, which has now become a standard defence.”
