Thirty women were huddled for safety in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. Several had recently given birth, while others were actively in labor.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “The sounds of screaming reached me of women and children,” he states. “A massacre was taking place inside the hospital. Survival meant running for your life.”
This brutal attack stands as a particularly egregious examples in the two-year civil war tearing the African nation apart. Armed soldiers stormed the facility, allegedly slaughtering more than 460 individuals receiving care and their families.
Rights organizations have labeled it “an unspeakable atrocity,” and a stark illustration of the vanishing safeguards for civilians trapped in war-torn areas in multiple global hotspots.
A Record of Violence Against Maternal Care
Despite every significant nation have signed the international laws of war, which obligate them to protect 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 uncover an unprecedented scale of attacks: nearly 300 incidents targeting or hindering places and people associated with childbirth 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 form a pattern of reproductive violence.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where countless of pregnant women are trapped.
Women have been killed, prevented from accessing care, or forced to give birth in deplorable situations. The data also indicates that at least 68 maternal health workers have been slain, 15 kidnapped, and 101 arrested—sometimes during medical procedures.
The Global Crisis in Maternal Health
These figures likely represent a grave undercount, as they are limited to incidents covered by the media. In many areas of fighting, information is scarce.
Last year, findings indicated that 50% of women who died during pregnancy or childbirth were in a conflict area. This underscores a catastrophic reality.
Apart from fatalities, these attacks are destroying maternal and neonatal care facilities, jeopardizing the future to demographic stability.
Conditions within Gaza
In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as one reason behind accusations of genocidal acts.
Despite periods of calm, doctors report that women and children succumb from a lack of proper treatment, owing to severe deficits of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals were out of reach.
“Our facility has endured missile strikes targeting the wards, operating rooms, and maternity wards,” states 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 maternity and neonatal facilities have been struck and ruined in Ukraine. Accounts from embattled medical centers describe births forced underground and skyrocketing stress leading to birth complications.
“The attacks on us are intentional,” claims 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 can strike a hospital.”
A Culture of Impunity
For the more than 676 million women living near active conflicts, there are scarce guarantees and a stark lack of legal accountability for those assaulting reproductive health.
This void of justice has fostered a “environment where anything goes,” says a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, may constitute acts of genocide by hindering reproduction.”
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 scarce because of a lack of access 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 faced detention, death, or harm over the past two years of civil war.
The End of Safe Deliveries
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, resulting in risky home births without skilled assistance.
“The deliberate attack on maternity wards points toward a broader and more sinister pattern: the use of attacks on medical facilities as a tool for terror and to tear apart the social fabric,” observes 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 increasingly been used as a justification.”
