A group of thirty mothers were seeking shelter in a maternity hospital in El Fasher, Sudan, as the slaughter began. Among them were new mothers, while others were in the midst of labor.
Working that night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “The sounds of screaming reached me of women and children,” he explains. “A massacre was taking place inside the hospital. We who were able to escape, did so.”
This brutal attack stands as among the worst examples in the ongoing war tearing the North African nation apart. Armed soldiers stormed the facility, reportedly killing more than 460 individuals receiving care and their families.
Rights organizations have called it “a crime beyond words,” and a clear case of the vanishing safeguards for civilians caught in conflict zones in several nations at war.
An Unprecedented Assault On Childbirth Services
Despite every significant nation 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. Mothers in labor are highly exposed due to their reliance on locally available medical care.
Data analysis and investigations reveal an alarming level of violence: nearly 300 incidents targeting or hindering maternity care facilities, staff, and pregnant women over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These are not inevitable outcomes of conflict. They represent a pattern of reproductive violence.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where countless of women bearing children are confined.
Mothers have lost their lives, blocked from reaching help, or forced to give birth in deplorable situations. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 abducted, and 101 detained—sometimes while assisting births.
The Global Crisis in Maternal Health
Statistics are thought to be a significant underestimate, as they capture solely incidents covered by the media. In many conflict zones, communications are sparse.
Last year, analysis showed that one in two mothers who died during pregnancy or childbirth lived amidst hostilities. This underscores a horrifying trend.
Beyond killing women and staff, these attacks are obliterating critical infrastructure for mothers and babies, jeopardizing the future to demographic stability.
Conditions within Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as part of the basis for accusations of genocidal acts.
Following truces, doctors report that women and children succumb from a lack of proper treatment, owing to critical shortages of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals could not be reached.
“Direct shelling fired at the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or aiming to influence birthrates.
Ukraine's Ordeal
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 forced underground and extreme psychological pressure leading to birth complications.
“The attacks on us are intentional,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“In fact, every facility is now a potential target,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”
A Culture of Impunity
For the hundreds of millions of women living within range of fighting, there are minimal protections and a stark lack of legal accountability for those attacking childbirth services.
This lack of accountability has led to a “environment where anything goes,” argues a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, are potentially 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 spiking dangerously, 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 faced detention, death, or harm over the past two years of civil war.
The End of Safe Deliveries
A large proportion of mother deaths are averted with basic healthcare, but war shatters health systems. Rights groups note that anxiety is forcing women away from facilities once considered safe, resulting in risky home births without skilled assistance.
“The deliberate attack on maternity wards speaks to a larger and alarming strategy: the use of attacks on medical facilities as a tool for terror and to break societal cohesion,” observes a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘militarily advantageous’, which has often been cited as an excuse.”
