A group of thirty mothers were seeking shelter in a childbirth facility in El Fasher, Sudan, when the massacre started. Among them were new mothers, while others were in the midst of labor.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “There were cries of women and children,” he states. “They were killing everyone inside the hospital. We who were able to escape, did so.”
This horrifying event stands as among the worst examples in the protracted internal conflict tearing the North African nation apart. Militiamen raided the hospital, reportedly killing more than 460 innocent people inside.
Rights organizations have labeled it “an act of unspeakable brutality,” and a clear case of the deteriorating protection for civilians caught in conflict zones in several nations at war.
A Record of Violence Against Maternal Care
While all major powers have signed the Geneva conventions, which obligate them to protect civilians, the past year has seen a record number of violence targeting health services. Women undergoing childbirth are particularly at risk due to their reliance on locally available medical care.
Data analysis and investigations reveal an shocking trend: nearly 300 incidents targeting or hindering maternity care facilities, staff, and pregnant women over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These are not inevitable outcomes of conflict. They represent a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where countless of pregnant women are trapped.
Women have been killed, blocked from reaching help, or compelled to deliver in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 taken hostage, and 101 arrested—sometimes while assisting births.
The Global Crisis in Maternal Health
Statistics are thought to be a substantial underreporting, as they capture solely incidents documented publicly. In many areas of fighting, information is scarce.
Last year, it was reported that half of all women who lost their lives in maternal circumstances resided in a war zone. This underscores a catastrophic reality.
Beyond killing women and staff, these attacks are obliterating maternal and neonatal care facilities, creating a grave danger to societal repopulation and recovery.
The Situation in 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 succumb from a lack of proper treatment, owing to desperate lacks of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals were out of reach.
“Direct shelling hitting the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or seeking to affect birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births taking place in basements and skyrocketing stress leading to birth complications.
“We are being singled out,” says 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. “When defensive systems shoot down an aircraft, the falling debris may hit a hospital.”
Accountability Evaporates
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 lack of accountability has led to a “atmosphere of lawlessness,” explains a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, may constitute acts of genocide by destroying a group's future.”
Additional Hotspots
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, causing fatalities among patients and staff.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have faced detention, death, or harm over the past two years of civil war.
The End of Safe Deliveries
The majority of childbirth fatalities 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 lacking professional help.
“When childbirth centers become intentional targets points toward a broader and more sinister pattern: 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 may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”
