A group of thirty mothers were huddled for safety 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.
On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “I heard the screams of women and children,” he explains. “A massacre was taking place inside the hospital. We who were able to escape, did so.”
This appalling incident stands as a particularly egregious examples in the protracted internal conflict tearing the African nation apart. Armed soldiers forced their way into the building, allegedly slaughtering more than 460 individuals receiving care and their families.
Rights organizations have labeled it “an unspeakable atrocity,” and a clear case of the collapse in safety for civilians caught in conflict zones in multiple global hotspots.
A Record of Violence On Childbirth Services
While all major powers are signatories to the international laws of war, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of assaults against medical infrastructure. Mothers in labor are exceptionally vulnerable due to their need for locally available medical care.
Research and compiled data show an unprecedented scale of attacks: nearly 300 attacks on and disruptions to places and people associated with childbirth over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These incidents do not represent inevitable outcomes of conflict. They represent a pattern of reproductive violence.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where hundreds of thousands of pregnant women are trapped.
Deaths have occurred, prevented from accessing care, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been slain, 15 abducted, and 101 detained—sometimes during medical procedures.
A Worldwide Emergency for Mothers and Newborns
Statistics are thought to be a substantial underreporting, as they only include incidents covered by the media. In many war-torn areas, communications are sparse.
Last year, analysis showed that half of all women who perished while pregnant or giving birth lived amidst hostilities. This underscores a horrifying trend.
Beyond killing women and staff, these attacks are destroying hospitals and wards, creating a grave danger to community survival.
The Situation in Gaza
In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as one reason behind declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children succumb from inadequate care, owing to desperate lacks of medicine and equipment. UN officials have relayed women having children by the roadside because hospitals were out of reach.
“Our facility has endured missile strikes hitting 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 seeking to affect birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 childbirth centers have been damaged or destroyed in Ukraine. Reports from frontline hospitals describe births forced underground and extreme psychological pressure leading to maternal health issues.
“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.
“The reality is, every facility can be under attack now,” comments a medical director in Sumy. “If a drone is destroyed, the falling debris could impact a hospital.”
Accountability Evaporates
For the hundreds of millions of women living near active conflicts, there are few safeguards and a stark lack of legal accountability for those targeting maternity care.
This absence of consequences has fostered a “environment where anything goes,” says a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, may constitute acts of genocide by destroying a group's future.”
Other Conflict Zones
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 limited by a communication blackout from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, killing mothers, babies, and nurses.
In Myanmar, clinics have been attacked 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
Most maternal deaths are avoidable with standard medicine, but war destroys healthcare networks. Rights groups note that terror is compelling women away from facilities once considered safe, leading them to risky home births lacking professional help.
“If maternity hospitals are being deliberately targeted speaks to a wider and more disturbing trend: the use of attacks on medical facilities as a tool for terror and to break societal cohesion,” 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 ‘prejudicial to the opposing side’, which has now become a standard defence.”
