Dozens of women were seeking shelter in a childbirth facility in El Fasher, Sudan, when the massacre started. Several had recently given birth, while others were actively in labor.
Present at the hospital after dark, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “There were cries of women and children,” he recounts. “They were killing everyone inside the hospital. Survival meant running for your life.”
This appalling incident stands as among the worst examples in the ongoing war tearing the African nation apart. Armed soldiers raided the hospital, allegedly slaughtering more than 460 innocent people inside.
Rights organizations have called it “a crime beyond words,” and a stark illustration of the vanishing safeguards for civilians trapped in war-torn areas in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault On Childbirth Services
Despite every significant nation have signed the international laws of war, which obligate them to protect civilians, the past year has seen a record number of attacks on healthcare systems. Women undergoing childbirth are particularly at risk due to their dependence on locally available medical care.
Research and compiled data show an alarming level of violence: nearly 300 incidents targeting or hindering 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 Ukraine, Gaza, and Sudan, where countless of women bearing children are confined.
Deaths have occurred, blocked from reaching help, or made to have their babies in deplorable situations. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 kidnapped, and 101 detained—sometimes while assisting births.
A Worldwide Emergency in Maternal Health
These figures likely represent a grave undercount, as they only include incidents reported in news outlets. In many conflict zones, reporting is limited.
Last year, analysis showed that one in two mothers who lost their lives in maternal circumstances lived amidst hostilities. This underscores a devastating pattern.
Apart from fatalities, these attacks are obliterating maternal and neonatal care facilities, jeopardizing the future to demographic stability.
The Situation in Gaza
In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as a factor in accusations of genocidal acts.
Even after ceasefires, doctors report that women and children continue to die from inadequate care, owing to critical shortages of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals were inaccessible.
“Direct shelling hitting the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has contested 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 struck and ruined in Ukraine. Reports from frontline hospitals describe births taking place in basements and skyrocketing stress leading to maternal health issues.
“Russia is targeting us deliberately,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“In fact, every facility can be under attack now,” states a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
A Culture of Impunity
For the over half a billion females living close to deadly warfare, there are minimal protections and even fewer war crimes prosecutions for those assaulting reproductive health.
This lack of accountability has created a “culture of impunity,” explains a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, can be understood as 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 increasing drastically, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is scarce because of a lack of access from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, causing fatalities among patients and staff.
In Myanmar, clinics have been attacked and dozens of midwives and patients have faced detention, death, or harm over the past two years of civil war.
The End of Safe Deliveries
A large proportion of mother deaths are averted with basic healthcare, but war shatters health systems. Rights groups note that anxiety is forcing 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 larger and alarming strategy: the use of violence against hospitals as a tool for terror and to break societal cohesion,” 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 often been cited as an excuse.”
