A group of thirty mothers were seeking shelter in a maternity hospital in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, while others were experiencing childbirth.
On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “There were cries of women and children,” he explains. “They were killing everyone inside the hospital. We who were able to escape, did so.”
This brutal attack stands as a particularly egregious examples in the ongoing war tearing the African nation apart. Combatants forced their way into the building, allegedly slaughtering more than 460 individuals receiving care and their families.
Rights organizations have described it as “an act of unspeakable brutality,” and a prime example of the deteriorating protection for civilians living amidst warfare in several nations at war.
A Record of Violence Against Maternal Care
While all major powers have signed the Geneva conventions, which obligate them to protect civilians, the past year has seen a record number of violence targeting health services. Mothers in labor 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 violent acts against places and people associated with childbirth over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“This is not inevitable outcomes of conflict. They represent a pattern of reproductive violence.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where hundreds of thousands of women bearing children are confined.
Deaths have occurred, denied medical attention, or compelled to deliver in deplorable situations. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 abducted, and 101 arrested—sometimes during medical procedures.
A Worldwide Emergency for Mothers and Newborns
Statistics are thought to be a substantial underreporting, as they are limited to incidents documented publicly. In many war-torn areas, reporting is limited.
Last year, findings indicated that 50% of women who perished while pregnant or giving birth lived amidst hostilities. This underscores a horrifying trend.
Beyond killing women and staff, these attacks are obliterating maternal and neonatal care facilities, creating a grave danger to community survival.
Conditions within Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as one reason behind declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children are still perishing from inadequate care, owing to critical shortages of medicine and equipment. Agencies have reported women having children by the roadside because hospitals were inaccessible.
“Our facility has endured missile strikes fired at 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 seeking to affect birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities have been struck and ruined in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and skyrocketing stress leading to problems during delivery.
“Russia is targeting us deliberately,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The truth of the matter is, every facility faces the threat of assault,” states a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
Accountability Evaporates
For the more than 676 million women living within range of fighting, there are minimal protections and rare trials for atrocities for those assaulting reproductive health.
This void of justice has fostered a “atmosphere of lawlessness,” explains a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by hindering reproduction.”
Other Conflict Zones
In El Fasher, the area lacked access to 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 restricted due to a communication blackout from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, resulting in tragic loss of life.
In Myanmar, hospitals have come under fire 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
The majority of childbirth fatalities are averted with basic healthcare, but war destroys healthcare networks. Rights groups note that anxiety is forcing women away from facilities once considered safe, resulting in risky home births devoid of emergency care.
“When childbirth centers become intentional targets points toward a broader and more sinister pattern: 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 are not inviolable if used for acts deemed ‘harmful to the enemy’, which has increasingly been used as a justification.”
