🔗 Share this article The Targeting of Childbirth: How Women and Babies Became Targets in Global Conflicts. Thirty women were huddled for safety in a childbirth facility 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, lived to tell the tale. “I heard the screams of women and children,” he states. “A massacre was taking place inside the hospital. We who were able to escape, did so.” This appalling incident stands as among the worst 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 called it “a crime beyond words,” 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. An Unprecedented Assault Against Maternal Care While all major powers are signatories to the Geneva conventions, which commit them to defending civilians, the past year has seen a record number of violence targeting health services. Mothers in labor are particularly at risk due to their need for locally available medical care. Data analysis and investigations uncover an alarming level of violence: nearly 300 attacks on and disruptions to maternity care facilities, staff, and pregnant women over the last three years, including at least 119 direct strikes on hospitals and delivery wards. “These are not inevitable outcomes of conflict. They represent a deliberate strategy of violence against reproduction.” The majority of these attacks have taken place in regions embroiled in intense conflict, where hundreds of thousands of pregnant women are trapped. Mothers have lost their lives, prevented from accessing care, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 abducted, and 101 arrested—sometimes while assisting births. The Global Crisis for Mothers and Newborns These figures likely represent a substantial underreporting, as they are limited to incidents documented publicly. In many conflict zones, communications are sparse. Last year, findings indicated that 50% of women who lost their lives in maternal circumstances were in a conflict area. This underscores a horrifying trend. Apart from fatalities, these attacks are wrecking hospitals and wards, creating a grave danger to demographic stability. The Situation in Gaza In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as one reason behind genocide allegations. Following truces, doctors report that women and children continue to die from medical shortages, owing to severe deficits of medicine and equipment. Accounts describe women having children by the roadside because hospitals were inaccessible. “Direct shelling fired at 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 aiming to influence birthrates. The Crisis in Ukraine Since early 2022, at least 80 childbirth centers have been struck and ruined in Ukraine. Accounts from embattled medical centers describe births forced underground and skyrocketing stress leading to maternal health issues. “The attacks on us are intentional,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians. “In fact, every facility can be under attack now,” comments 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 over half a billion females living near active conflicts, there are few safeguards and even fewer war crimes prosecutions for those attacking childbirth services. This absence of consequences has led to a “atmosphere of lawlessness,” argues 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 had been cut off 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 limited by a inability to report from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, causing fatalities among patients and staff. 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 avoidable with standard medicine, but war shatters health systems. Rights groups note that fear is now driving women away from facilities once considered safe, leading them to risky home births lacking professional help. “When childbirth centers become intentional targets indicates 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. “Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has often been cited as an excuse.”