A group of thirty mothers were huddled for safety in a maternity hospital 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. “I heard the screams of women and children,” he explains. “They executed everybody inside the hospital. Those who could run, fled.”
This appalling incident stands as among the worst examples in the ongoing war tearing the African nation apart. Combatants forced their way into the building, reportedly killing more than 460 patients and their companions.
Rights organizations have described it as “a crime beyond words,” and a prime example of the vanishing safeguards for civilians living amidst warfare in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault On Childbirth Services
Despite every significant nation have signed the international laws of war, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of assaults against medical infrastructure. Expectant mothers are exceptionally vulnerable due to their need for locally available medical care.
Data analysis and investigations show an alarming level of violence: nearly 300 attacks on and disruptions to places and people associated with childbirth over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“These are not standard wartime hazards. They form a systematic assault on childbirth.”
The majority of these incidents have happened in regions embroiled in intense conflict, where countless of expectant mothers are stranded.
Mothers have lost their lives, prevented from accessing care, 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 kidnapped, and 101 arrested—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
Statistics are thought to be a grave undercount, as they capture solely incidents reported in news outlets. In many war-torn areas, reporting is limited.
Last year, analysis showed that half of all women who perished while pregnant or giving birth resided in a war zone. This underscores a devastating pattern.
In addition to the loss of life, these attacks are destroying critical infrastructure for mothers and babies, jeopardizing the future to community survival.
The Situation in Gaza
In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as part of the basis for genocide allegations.
Following truces, doctors report that women and children continue to die from medical shortages, owing to desperate lacks of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals were inaccessible.
“We’ve had rockets 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 seeking to affect birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities have been damaged or destroyed in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and skyrocketing stress leading to maternal health issues.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The reality is, every facility is now a potential target,” comments a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris may hit a hospital.”
Accountability Evaporates
For the hundreds of millions of women living within range of fighting, there are scarce guarantees and a stark lack of legal accountability for those targeting maternity care.
This void of justice has fostered a “culture of impunity,” argues a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by hindering reproduction.”
Additional Hotspots
In El Fasher, the area was isolated from 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 scarce because of a communication blackout from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, causing fatalities among patients and staff.
In Myanmar, hospitals have come under fire and dozens of midwives and patients have suffered violence over the past two years of civil war.
The End of Safe Deliveries
A large proportion of mother deaths are averted with basic healthcare, but war destroys healthcare networks. Rights groups note that fear is now driving women away from facilities once considered safe, pushing them toward risky home births without skilled assistance.
“When childbirth centers become intentional targets 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 are not inviolable if used for acts deemed ‘militarily advantageous’, which has often been cited as an excuse.”