A group of thirty mothers were huddled for safety in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. Some had just delivered their newborns, while others were in the midst of 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 explains. “They were killing everyone inside the hospital. Those who could run, fled.”
This horrifying event stands as a particularly egregious examples in the two-year civil war tearing the African nation apart. Militiamen forced their way into the building, allegedly slaughtering more than 460 individuals receiving care and their families.
Rights organizations have called it “a crime beyond words,” and a clear case of the deteriorating protection for civilians trapped in war-torn areas in several nations at war.
An Unprecedented Assault Against Maternal Care
While all major powers have agreed to the international laws of war, which obligate them to protect civilians, the past year has experienced a historic high of assaults against medical infrastructure. Women undergoing childbirth are exceptionally vulnerable due to their reliance on locally available medical care.
Research and compiled data uncover an shocking trend: nearly 300 attacks on and disruptions to maternity care facilities, staff, and pregnant women over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“These incidents do not represent standard wartime hazards. They form a pattern of reproductive violence.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where countless of expectant mothers are stranded.
Deaths have occurred, prevented from accessing care, or made to have their babies in dangerous and unsanitary conditions. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 taken hostage, and 101 arrested—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
The numbers are probably a substantial underreporting, as they capture solely incidents documented publicly. In many war-torn areas, communications are sparse.
Last year, analysis showed that half of all women who perished while pregnant or giving birth were in a conflict area. This underscores a devastating pattern.
In addition to the loss of life, these attacks are wrecking maternal and neonatal care facilities, posing a long-term threat to demographic stability.
Conditions within Gaza
In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as part of the basis for accusations of genocidal acts.
Despite periods of calm, doctors report that women and children are still perishing from medical shortages, owing to desperate lacks of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals were inaccessible.
“Direct shelling 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 aiming to influence birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and extreme psychological pressure leading to maternal health issues.
“We are being singled out,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“In fact, every facility is now a potential target,” comments a medical director in Sumy. “If a drone is destroyed, the falling debris could impact a hospital.”
Accountability Evaporates
For the more than 676 million women living within range of fighting, there are few safeguards and a stark lack of legal accountability for those attacking childbirth services.
This void of justice has created a “environment where anything goes,” says 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 limited by a inability to report from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, killing mothers, babies, and nurses.
In Myanmar, clinics have been attacked and dozens of midwives and patients have suffered violence over the past two years of civil war.
The End of Safe Deliveries
The majority of childbirth fatalities are preventable with routine care, but war destroys healthcare networks. Rights groups note that anxiety is forcing women away from facilities once considered safe, leading them to risky home births without skilled assistance.
“The deliberate attack on maternity wards indicates a larger and alarming strategy: the use of violence against hospitals as a tool for terror 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 now become a standard defence.”
