Thirty 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.
Present at the hospital after dark, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “The sounds of screaming reached me of women and children,” he explains. “A massacre was taking place inside the hospital. Those who could run, fled.”
This appalling incident stands as among the worst examples in the two-year civil war tearing the African nation apart. Armed soldiers stormed the facility, reportedly killing more than 460 patients and their companions.
Rights organizations have described it as “an act of unspeakable brutality,” and a clear case of the deteriorating protection for civilians trapped in war-torn areas in multiple global hotspots.
An Unprecedented Assault Against Maternal Care
Despite every significant nation are signatories to the international laws of war, which obligate them to protect civilians, the past year has experienced a historic high of violence targeting health services. Expectant mothers are highly exposed due to their reliance on locally available medical care.
Data analysis and investigations show an alarming level of violence: 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 inevitable outcomes of conflict. They form a systematic assault on childbirth.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where hundreds of thousands of pregnant women are trapped.
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 murdered, 15 taken hostage, and 101 detained—sometimes during medical procedures.
The Global Crisis for Mothers and Newborns
The numbers are probably a substantial underreporting, as they capture solely incidents documented publicly. In many war-torn areas, communications are sparse.
Last year, it was reported that one in two mothers who died during pregnancy or childbirth resided in a war zone. This underscores a catastrophic reality.
Apart from fatalities, these attacks are obliterating hospitals and wards, creating a grave danger 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 a factor in accusations of genocidal acts.
Despite periods of calm, doctors report that women and children continue to die from inadequate care, owing to critical shortages of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals were out of reach.
“Direct shelling targeting the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has rejected 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 birth complications.
“The attacks on us are intentional,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“In fact, every facility can be under attack now,” notes 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 minimal protections and even fewer war crimes prosecutions for those assaulting reproductive health.
This void of justice has fostered a “culture of impunity,” explains a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, may constitute acts of genocide by preventing births.”
Other Conflict Zones
In El Fasher, the area had been cut off from 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 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 Collapse of Safe Childbirth
Most maternal deaths are avoidable with standard medicine, 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 lacking professional help.
“When childbirth centers become intentional targets indicates a wider and more disturbing trend: the use of violence against hospitals as a tool for terror and to break societal cohesion,” notes a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘harmful to the enemy’, which has now become a standard defence.”
