A group of thirty mothers had taken refuge in a childbirth facility in El Fasher, Sudan, as the slaughter began. Several had recently given birth, while others were actively in labor.
On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “There were cries of women and children,” he states. “They were killing everyone inside the hospital. Survival meant running for your life.”
This brutal attack stands as among the worst examples in the two-year civil war tearing the African nation apart. Militiamen stormed the facility, reportedly killing more than 460 individuals receiving care and their families.
Rights organizations have labeled it “a crime beyond words,” and a clear case of the collapse in safety for civilians living amidst warfare in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence Against Maternal Care
Although world powers have signed the Geneva conventions, which commit them to defending civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Mothers in labor are highly exposed due to their dependence on locally available medical care.
Research and compiled data reveal an shocking trend: nearly 300 incidents targeting or hindering places and people associated with childbirth over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“This is not standard wartime hazards. They represent a pattern of reproductive violence.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where a vast number of expectant mothers are stranded.
Deaths have occurred, prevented from accessing care, or made to have their babies in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 taken hostage, and 101 detained—sometimes during medical procedures.
A Worldwide Emergency for Mothers and Newborns
These figures likely represent a grave undercount, as they capture solely incidents reported in news outlets. In many areas of fighting, information is scarce.
Last year, it was reported that half of all women who perished while pregnant or giving birth were in a conflict area. This underscores a horrifying trend.
Beyond killing women and staff, these attacks are obliterating maternal and neonatal care facilities, jeopardizing the future to societal repopulation and recovery.
The Situation in Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as one reason behind declaring certain actions a genocide.
Following truces, doctors report that women and children are still perishing from inadequate care, owing to critical shortages of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals were out of reach.
“Our facility has endured missile strikes targeting 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 attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and extreme psychological pressure leading to problems during delivery.
“Russia is targeting us deliberately,” claims 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,” states a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris could impact a hospital.”
A Culture of Impunity
For the hundreds of millions of women living close to deadly warfare, there are scarce guarantees and rare trials for atrocities for those targeting maternity care.
This absence of consequences has created a “atmosphere of lawlessness,” argues a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, are potentially acts of genocide by destroying a group's future.”
Other Conflict Zones
In El Fasher, the area had been cut off from humanitarian aid long before the hospital attack, with malnutrition rising sharply, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is scarce because of 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 End of Safe Deliveries
The majority of childbirth fatalities are averted with basic healthcare, but war shatters health systems. Rights groups note that fear is now driving women away from facilities once considered safe, pushing them toward risky home births devoid of emergency care.
“When childbirth centers become intentional targets indicates a larger and alarming strategy: the use of attacks on medical facilities as a weapon to spread fear and to break societal cohesion,” says a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘prejudicial to the opposing side’, which has now become a standard defence.”
