A group of thirty mothers had taken refuge 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, Abdo-Rabo Ahmed, managed to survive the ordeal. “There were cries of women and children,” he explains. “A massacre was taking place inside the hospital. Those who could run, fled.”
This brutal attack stands as one of the most shocking examples in the protracted internal conflict tearing the North African nation apart. Combatants stormed the facility, reportedly killing more than 460 innocent people inside.
Rights organizations have called it “an act of unspeakable brutality,” and a clear case of the vanishing safeguards for civilians living amidst warfare in multiple global hotspots.
A Record of Violence On Childbirth Services
Although world powers are signatories to the international laws of war, which obligate them to protect civilians, the past year has seen a record number of attacks on healthcare systems. Women undergoing childbirth are particularly at risk due to their reliance on locally available medical care.
Data analysis and investigations uncover an shocking trend: nearly 300 violent acts against 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 standard wartime hazards. They form a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where countless of women bearing children are confined.
Women have been killed, denied medical attention, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 kidnapped, and 101 detained—sometimes in the act of delivering babies.
The Global Crisis for Mothers and Newborns
These figures likely represent a significant underestimate, as they only include incidents documented publicly. In many areas of fighting, communications are sparse.
Last year, findings indicated that one in two mothers who died during pregnancy or childbirth were in a conflict area. This underscores a horrifying trend.
In addition to the loss of life, these attacks are wrecking critical infrastructure for mothers and babies, posing a long-term threat to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as one reason behind declaring certain actions a genocide.
Despite periods of calm, doctors report that women and children continue to die from inadequate care, owing to desperate lacks of medicine and equipment. Agencies have reported women delivering babies amidst ruins because hospitals could not be reached.
“Our facility has endured missile strikes targeting the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or aiming to influence birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been attacked and rendered unusable in Ukraine. Reports from frontline hospitals describe births occurring in shelters and extreme psychological pressure leading to maternal health issues.
“The attacks on us are intentional,” claims 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 may hit a hospital.”
A Culture of Impunity
For the over half a billion females living near active conflicts, there are scarce guarantees and even fewer war crimes prosecutions for those attacking childbirth services.
This absence of consequences has led to a “culture of impunity,” argues a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, can be understood as 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 spiking dangerously, 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 struck a baby care unit, resulting in tragic loss of life.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have suffered violence over the past two years of civil war.
The Collapse of Safe Childbirth
Most maternal deaths are averted with basic healthcare, but war shatters health systems. Rights groups note that terror is compelling women away from facilities once considered safe, leading them to risky home births devoid of emergency care.
“If maternity hospitals are being deliberately targeted points toward a larger and alarming strategy: the use of attacks on medical facilities as a weapon to spread fear and to tear apart the social fabric,” says 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 ‘harmful to the enemy’, which has often been cited as an excuse.”
