Dozens of women were huddled for safety in a childbirth facility in El Fasher, Sudan, as the slaughter began. Among them were new mothers, while others were actively in labor.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “There were cries of women and children,” he states. “They executed everybody inside the hospital. Survival meant running for your life.”
This appalling incident stands as among the worst examples in the protracted internal conflict tearing the African nation apart. Militiamen stormed the facility, allegedly slaughtering more than 460 patients and their companions.
Rights organizations have described it as “an unspeakable atrocity,” and a prime example of the collapse in safety for civilians trapped in war-torn areas in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence Against Maternal Care
While all major powers are signatories to the Geneva conventions, which require them to safeguard civilians, the past year has experienced a historic high of assaults against medical infrastructure. Expectant mothers are particularly at risk due to their dependence on locally available medical care.
Data analysis and investigations reveal an unprecedented scale of attacks: 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.
“This is not natural consequences of war. They represent a systematic assault on childbirth.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where hundreds of thousands of women bearing children are confined.
Women have been killed, 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 slain, 15 abducted, and 101 arrested—sometimes in the act of delivering babies.
The Global Crisis for Mothers and Newborns
Statistics are thought to be a significant underestimate, as they are limited to incidents documented publicly. In many conflict zones, information is scarce.
Last year, it was reported that one in two mothers who died during pregnancy or childbirth lived amidst hostilities. This underscores a devastating pattern.
Apart from fatalities, these attacks are wrecking hospitals and wards, jeopardizing the future to community survival.
Conditions within Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as a factor in genocide allegations.
Despite periods of calm, doctors report that women and children continue to die from medical shortages, owing to desperate lacks of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals could not be reached.
“We’ve had rockets targeting the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or seeking to affect birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births forced underground and skyrocketing stress leading to birth complications.
“We are being singled out,” says 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,” notes a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris can strike a hospital.”
Accountability Evaporates
For the hundreds of millions of women living within range of fighting, there are minimal protections and even fewer war crimes prosecutions for those assaulting reproductive health.
This lack of accountability has created a “culture of impunity,” argues a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by destroying a group's future.”
Additional Hotspots
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 restricted due to a inability to report from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, killing mothers, babies, and nurses.
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 Collapse of Safe Childbirth
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, resulting in risky home births lacking professional help.
“The deliberate attack on maternity wards indicates a larger and alarming strategy: the use of attacks on medical facilities as a tool for terror and to tear apart the social fabric,” notes 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 now become a standard defence.”
