Death in the Streets: Childbirth Amid War in Sudan

In war-torn Sudan, pregnant women are facing unimaginable challenges as they strive to give birth amidst ongoing conflict. With hospitals and maternity wards shutting down, artillery fire, and road checkpoints, expectant mothers are risking their lives and those of their babies to reach medical care. The situation has reached a critical point, with doctors and aid workers warning of a looming humanitarian catastrophe.

The conflict, which has entered its second month, involves the Sudanese Army led by Gen. Abdel Fattah al-Burhan and the paramilitary Rapid Support Forces led by Lt. Gen. Mohamed Hamdan. Despite a recent seven-day ceasefire agreement between the two sides, sporadic gunfire and explosions continue to be heard in parts of the capital, Khartoum, and surrounding areas.

Before the fighting began, Sudan already had one of the highest maternal mortality rates in the world. Now, with over 1.1 million pregnant women in the country, the situation is dire. According to the United Nations Population Fund, more than 29,000 women are expected to give birth in the next month, with at least 4,300 in urgent need of emergency obstetric care, including C-sections. The collapse of the public health system exacerbates the risks faced by pregnant women.

Midwives and medical professionals are working tirelessly to provide assistance, often operating without ambulances or transportation options. They brave violence, navigate checkpoints, and respond to emergency calls amidst the chaos of war. However, they are severely limited by a lack of supplies and the degraded communication networks due to the conflict.

Dr. Mohamed Fath Alrahman, a pediatrician and general manager of Al-Nada hospital in Omdurman, highlights the immense challenges faced by expectant mothers. The hospital, one of the few still operational in greater Khartoum, is overwhelmed with pregnant women seeking care. Dr. Fath recounts the harrowing story of a woman who arrived in advanced labor after enduring hours at a checkpoint where her husband was being interrogated. Tragically, the baby did not survive.

The conflict has led to a surge in premature births, with the number of preterm babies in Dr. Fath's hospital increasing by almost a third since the fighting began. The facility, operating with a skeletal staff, has delivered over 600 newborns in the past month alone, compared to their usual rate. The strain on resources is evident, with multiple C-sections performed daily and newborns forced to share incubators.

While international funding from organizations such as the Sudanese American Physicians Association has helped keep some hospitals functioning, the broader collapse of Sudan's public health system has had devastating consequences. Hospitals have become battlegrounds, with armed groups using health centers as bases and forcibly evicting patients. Looting and the closure of pharmacies and warehouses have further compounded the crisis, leaving patients with chronic diseases without medication.

Midwives have emerged as vital lifelines for pregnant women, providing care in their homes and navigating dangerous situations to ensure safe deliveries. However, they face significant obstacles, including the risks associated with street fighting and the scarcity of medical supplies.

Despite the challenges and dangers they face, midwives like Amna Al-Ahmad and Ahlam Abdullah Hamid remain committed to their work. They respond to emergency calls, often posted on neighborhood WhatsApp channels, and deliver babies in the midst of the conflict. These midwives exemplify the spirit of dedication and selflessness in the face of adversity.