Dozens of women were seeking shelter in a childbirth facility in El Fasher, Sudan, as the slaughter began. Several had recently given birth, while others were actively in labor.
Working that night, 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. “They were killing everyone inside the hospital. Survival meant running for your life.”
This brutal attack stands as among the worst examples in the protracted internal conflict tearing the African nation apart. Militiamen stormed the facility, leaving dead more than 460 patients and their companions.
Rights organizations have described it as “a crime beyond words,” and a stark illustration of the collapse in safety for civilians living amidst warfare in several nations at war.
A Record of Violence Against Maternal Care
While all major powers are signatories to the international laws of war, which require them to safeguard civilians, the past year has experienced a historic high of violence targeting health services. Women undergoing childbirth are exceptionally vulnerable due to their need for locally available medical care.
Research and compiled data reveal an unprecedented scale of attacks: nearly 300 violent acts against places and people associated with childbirth over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“This is not natural consequences of war. 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 expectant mothers are stranded.
Women have been killed, blocked from reaching help, or compelled to deliver in dangerous and unsanitary conditions. The data also indicates that at least 68 maternal health workers have been killed, 15 kidnapped, and 101 arrested—sometimes in the act of delivering babies.
A Worldwide Emergency in Maternal Health
Statistics are thought to be a significant underestimate, as they only include incidents reported in news outlets. In many war-torn areas, information is scarce.
Last year, analysis showed that half of all women who perished while pregnant or giving birth resided in a war zone. This underscores a catastrophic reality.
In addition to the loss of life, these attacks are destroying critical infrastructure for mothers and babies, jeopardizing the future to community survival.
Conditions within Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as part of the basis for accusations of genocidal acts.
Following truces, doctors report that women and children continue to die 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.
“Our facility has endured missile strikes fired at 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 aiming to influence birthrates.
The Crisis in Ukraine
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 occurring in shelters and skyrocketing stress leading to birth complications.
“Russia is targeting us deliberately,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied 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 may hit a hospital.”
Accountability Evaporates
For the hundreds of millions of women living near active conflicts, there are scarce guarantees and even fewer war crimes prosecutions for those targeting maternity care.
This absence of consequences has fostered a “environment where anything goes,” explains a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, are potentially acts of genocide by preventing births.”
Additional Hotspots
In El Fasher, the area lacked access to humanitarian aid long before the hospital attack, with malnutrition rising sharply, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is limited by a communication blackout from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, 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 End of Safe Deliveries
Most maternal deaths are averted with basic healthcare, but war collapses medical infrastructure. Rights groups note that terror is compelling women away from facilities once considered safe, leading them to risky home births without skilled assistance.
“The deliberate attack on maternity wards points toward a larger and alarming strategy: the use of violence against hospitals as a weapon to spread fear and to destroy community bonds,” says a legal researcher.
“Safeguards are not guaranteed 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 now become a standard defence.”
