The Targeting of Childbirth: How Women and Babies Became Casualties in Worldwide Wars.

A group of thirty mothers had taken refuge in a maternity hospital in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, while others were experiencing childbirth.

Present at the hospital after dark, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “There were cries of women and children,” he recounts. “A massacre was taking place 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 North African nation apart. Combatants stormed the facility, allegedly slaughtering more than 460 innocent people inside.

Rights organizations have labeled it “a crime beyond words,” and a prime example of the vanishing safeguards for civilians trapped in war-torn areas in several nations at war.

An Unprecedented Assault On Childbirth Services

While all major powers have agreed to the international laws of war, which commit them to defending civilians, the past year has experienced a historic high of attacks on healthcare systems. Expectant mothers are highly exposed due to their reliance 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 bombardments of hospitals and delivery wards.

“These are not natural consequences of war. They constitute a deliberate strategy of violence against reproduction.”

The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where hundreds of thousands of pregnant women are trapped.

Women have been killed, blocked from reaching help, or made to have their babies in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 kidnapped, and 101 detained—sometimes while assisting births.

The Global Crisis for Mothers and Newborns

The numbers are probably a substantial underreporting, as they capture solely incidents reported in news outlets. In many war-torn areas, reporting is limited.

Last year, analysis showed that 50% of women who perished while pregnant or giving birth resided in a war zone. This underscores a devastating pattern.

In addition to the loss of life, these attacks are wrecking hospitals and wards, jeopardizing the future to demographic stability.

The Situation in Gaza

In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as part of the basis for declaring certain actions a genocide.

Even after ceasefires, doctors report that women and children continue to die from medical shortages, owing to desperate lacks of medicine and equipment. Accounts describe women giving birth in rubble because hospitals could not be reached.

“Direct shelling targeting 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 struck and ruined in Ukraine. Reports from frontline hospitals describe births occurring in shelters and extreme psychological pressure leading to maternal health issues.

“Russia is targeting us deliberately,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.

“The reality is, every facility is now a potential target,” comments a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris could impact a hospital.”

Accountability Evaporates

For the hundreds of millions of women living near active conflicts, there are minimal protections and even fewer war crimes prosecutions for those assaulting reproductive health.

This absence of consequences has fostered a “atmosphere of lawlessness,” says a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, may constitute acts of genocide by preventing births.”

Additional Hotspots

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 scarce because of a inability to report from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, killing mothers, babies, and nurses.

In Myanmar, hospitals have come under fire and dozens of midwives and patients have suffered violence over the past two years of civil war.

The End of Safe Deliveries

Most maternal deaths are averted with basic healthcare, 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 devoid of emergency care.

“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,” observes a legal researcher.

“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘prejudicial to the opposing side’, which has often been cited as an excuse.”