Thirty women had taken refuge in a childbirth facility in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, 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. “I heard the screams of women and children,” he recounts. “They executed everybody inside the hospital. Those who could run, fled.”
This brutal attack stands as one of the most shocking examples in the two-year civil war tearing the North 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 clear case of the vanishing safeguards for civilians trapped in war-torn areas in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence Against Maternal Care
While all major powers are signatories to the international laws of war, which commit them to defending civilians, the past year has seen a record number of violence targeting health services. Women undergoing childbirth are exceptionally vulnerable due to their reliance on locally available medical care.
Research and compiled data uncover an unprecedented scale of attacks: nearly 300 attacks on and disruptions to maternity care facilities, staff, and pregnant women over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These incidents do not represent natural consequences of war. They constitute a deliberate strategy of violence against reproduction.”
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, prevented from accessing care, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been slain, 15 taken hostage, and 101 arrested—sometimes in the act of delivering babies.
The Global Crisis in Maternal Health
Statistics are thought to be a substantial underreporting, as they are limited to incidents covered by the media. In many war-torn areas, reporting is limited.
Last year, analysis showed that half of all women 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, jeopardizing the future to community survival.
The Situation in Gaza
In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as one reason behind genocide allegations.
Following truces, doctors report that women and children succumb from a lack of proper treatment, owing to desperate lacks of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals could not be reached.
“We’ve had rockets fired at the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or aiming to influence birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 hospitals for mothers and babies have been damaged or destroyed in Ukraine. Accounts from embattled medical centers describe births taking place in basements and skyrocketing stress leading to maternal health issues.
“We are being singled out,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“In fact, every facility is now a potential target,” notes a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris may hit a hospital.”
Accountability Evaporates
For the over half a billion females living close to deadly warfare, there are minimal protections and a stark lack of legal accountability for those targeting maternity care.
This lack of accountability has created a “environment where anything goes,” argues a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, are potentially acts of genocide by preventing births.”
Other Conflict Zones
In El Fasher, the area was isolated 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 restricted due to a communication blackout from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, resulting in tragic loss of life.
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 preventable with routine care, but war shatters health systems. Rights groups note that terror is compelling women away from facilities once considered safe, resulting in risky home births devoid of emergency care.
“The deliberate attack on maternity wards points toward a wider and more disturbing trend: the use of violence against hospitals as a tool for terror 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 now become a standard defence.”
