Thirty women had taken refuge in a childbirth facility in El Fasher, Sudan, as the slaughter began. Several had recently given birth, while others were actively in labor.
Working that night, a 28-year-old lab technician, a technician named 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. We who were able to escape, did so.”
This brutal attack stands as one of the most shocking examples in the two-year civil war tearing the African nation apart. Militiamen forced their way into the building, leaving dead more than 460 innocent people inside.
Rights organizations have labeled it “an act of unspeakable brutality,” and a prime example of the collapse in safety for civilians living amidst warfare in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence On Childbirth Services
While all major powers are signatories to the Geneva conventions, which obligate them to protect civilians, the past year has experienced a historic high of violence targeting health services. Mothers in labor are particularly at risk due to their dependence on locally available medical care.
An investigation of records uncover 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 natural consequences of war. They form a deliberate strategy of violence against reproduction.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where countless of women bearing children are confined.
Mothers have lost their lives, prevented from accessing care, or compelled to deliver in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 kidnapped, and 101 taken into custody—sometimes while assisting births.
A Worldwide Emergency for Mothers and Newborns
Statistics are thought to be a grave undercount, as they capture solely incidents covered by the media. In many areas of fighting, communications are sparse.
Last year, analysis showed that half of all women who lost their lives in maternal circumstances resided in a war zone. This underscores a horrifying trend.
Beyond killing women and staff, these attacks are wrecking hospitals and wards, creating a grave danger 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.
Even after ceasefires, doctors report that women and children succumb from medical shortages, 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 hitting the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or seeking to affect birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 childbirth centers have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers 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.
“The reality is, 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 over half a billion females living close to deadly warfare, there are scarce guarantees and even fewer war crimes prosecutions for those targeting maternity care.
This void of justice has led to a “environment where anything goes,” says a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, are potentially acts of genocide by preventing births.”
Other Conflict Zones
In El Fasher, the area lacked access to 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 scarce because of a inability to report from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, killing mothers, babies, and nurses.
In Myanmar, clinics have been attacked and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The Collapse of Safe Childbirth
Most maternal 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, 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 weapon to spread fear and to destroy community bonds,” says a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘militarily advantageous’, which has often been cited as an excuse.”
