Thirty women were seeking shelter in a maternity hospital in El Fasher, Sudan, as the slaughter began. Some had just delivered their newborns, while others were actively in labor.
Present at the hospital after dark, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “I heard the screams of women and children,” he recounts. “They were killing everyone inside the hospital. Those who could run, fled.”
This horrifying event stands as among the worst examples in the two-year civil war tearing the African nation apart. Combatants raided the hospital, leaving dead more than 460 individuals receiving care and their families.
Rights organizations have described it as “an act of unspeakable brutality,” and a stark illustration of the collapse in safety for civilians trapped in war-torn areas in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault On Childbirth Services
Although world powers have agreed to 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 particularly at risk due to their need for locally available medical care.
Data analysis and investigations uncover an shocking trend: nearly 300 incidents targeting or hindering places and people associated with childbirth over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These are not standard wartime hazards. They form a deliberate strategy of violence against reproduction.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where a vast number of women bearing children are confined.
Mothers have lost their lives, denied medical attention, or compelled to deliver in deplorable situations. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 kidnapped, and 101 detained—sometimes during medical procedures.
The Global Crisis in Maternal Health
Statistics are thought to be a substantial underreporting, as they capture solely incidents reported in news outlets. In many areas of fighting, communications are sparse.
Last year, findings indicated that half of all women who died during pregnancy or childbirth resided in a war zone. This underscores a horrifying trend.
In addition to the loss of life, these attacks are destroying critical infrastructure for mothers and babies, jeopardizing the future to demographic stability.
The Situation in Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as part of the basis for accusations of genocidal acts.
Even after ceasefires, doctors report that women and children are still perishing from inadequate care, owing to desperate lacks of medicine and equipment. Accounts describe women having children by the roadside because hospitals were out of reach.
“Direct shelling targeting the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or trying to alter birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities have been attacked and rendered unusable in Ukraine. Reports from frontline hospitals describe births taking place in basements and extreme psychological pressure leading to maternal health issues.
“The attacks on us are intentional,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“In fact, every facility faces the threat of assault,” states a medical director in Sumy. “If a drone is destroyed, the falling debris could impact a hospital.”
A Culture of Impunity
For the hundreds of millions of women living within range of fighting, there are few safeguards and a stark lack of legal accountability for those assaulting reproductive health.
This absence of consequences has led to a “culture of impunity,” says a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, are potentially acts of genocide by preventing births.”
Other Conflict Zones
In El Fasher, the area was isolated 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 restricted due to a lack of access from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, resulting in tragic loss of life.
In Myanmar, hospitals have come under fire 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 averted with basic healthcare, but war collapses medical infrastructure. Rights groups note that anxiety is forcing women away from facilities once considered safe, resulting in risky home births without skilled assistance.
“When childbirth centers become intentional targets points toward a wider and more disturbing trend: the use of attacks on medical facilities as a weapon to spread fear and to destroy community bonds,” observes a legal researcher.
“Hospitals are not completely safe 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 often been cited as an excuse.”
