A group of thirty mothers were huddled for safety in a childbirth facility in El Fasher, Sudan, as the slaughter began. Several had recently given birth, while others were experiencing childbirth.
On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, became one of the few known survivors. “I heard the screams of women and children,” he recounts. “They executed everybody inside the hospital. We who were able to escape, did so.”
This horrifying event stands as one of the most shocking examples in the protracted internal conflict tearing the North African nation apart. Combatants raided the hospital, reportedly killing more than 460 innocent people inside.
Rights organizations have described it as “an act of unspeakable brutality,” and a clear case of the deteriorating protection for civilians caught in conflict zones in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault On Childbirth Services
While all major powers have agreed to the Geneva conventions, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of attacks on healthcare systems. Mothers in labor are particularly at risk due to their dependence on locally available medical care.
An investigation of records reveal an shocking trend: nearly 300 attacks on and disruptions to places and people associated with childbirth over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“These are not standard wartime hazards. They constitute a deliberate strategy of violence against reproduction.”
The majority of these incidents have happened in regions embroiled in intense conflict, where a vast number of expectant mothers are stranded.
Women have been killed, prevented from accessing care, or forced to give birth in dangerous and unsanitary conditions. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been killed, 15 taken hostage, and 101 arrested—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
Statistics are thought to be a significant underestimate, as they only include incidents documented publicly. In many war-torn areas, reporting is limited.
Last year, analysis showed that 50% of women who perished while pregnant or giving birth resided in a war zone. This underscores a catastrophic reality.
Beyond killing women and staff, these attacks are wrecking hospitals and wards, jeopardizing the future to community survival.
The Situation in Gaza
In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as part of the basis for genocide allegations.
Despite periods of calm, doctors report that women and children are still perishing from medical shortages, owing to critical shortages of medicine and equipment. Agencies have reported women delivering babies amidst ruins because hospitals could not be reached.
“Our facility has endured missile strikes hitting 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 seeking to affect birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 hospitals for mothers and babies have been struck and ruined in Ukraine. Accounts from embattled medical centers describe births taking place in basements and skyrocketing stress leading to maternal health issues.
“We are being singled out,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The truth of the matter is, every facility is now a potential target,” comments a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
Accountability Evaporates
For the hundreds of millions of women living close to deadly warfare, there are few safeguards 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. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, are potentially acts of genocide by hindering reproduction.”
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 scarce because of a communication blackout 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 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 fear is now driving women away from facilities once considered safe, leading them to risky home births devoid of emergency care.
“The deliberate attack on maternity wards speaks to a larger and alarming strategy: the use of violence against hospitals as a weapon to spread fear and to break societal cohesion,” says a legal researcher.
“Hospitals are not completely safe 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 increasingly been used as a justification.”
