Dozens of women were huddled for safety in a maternity hospital in El Fasher, Sudan, as the slaughter began. Several had recently given birth, while others were in the midst of labor.
On duty during that fateful 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 recounts. “They were killing everyone inside the hospital. Those who could run, fled.”
This brutal attack stands as among the worst examples in the two-year civil war tearing the North African nation apart. Militiamen forced their way into the building, allegedly slaughtering more than 460 innocent people inside.
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.
A Record of Violence Against Maternal Care
Despite every significant nation have agreed to the international laws of war, which commit them to defending civilians, the past year has experienced a historic high of violence targeting health services. Mothers in labor are exceptionally vulnerable due to their need for locally available medical care.
Research and compiled data uncover an shocking trend: nearly 300 attacks on and disruptions to places and people associated with childbirth over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These incidents do not represent inevitable outcomes of conflict. They form a systematic assault on childbirth.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where hundreds of thousands of pregnant women are trapped.
Deaths have occurred, blocked from reaching help, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been slain, 15 taken hostage, and 101 taken into custody—sometimes while assisting births.
The Global Crisis for Mothers and Newborns
These figures likely represent a significant underestimate, as they only include incidents documented publicly. In many conflict zones, information is scarce.
Last year, findings indicated that 50% of women who lost their lives in maternal circumstances resided in a war zone. This underscores a devastating pattern.
In addition to the loss of life, these attacks are wrecking hospitals and wards, posing a long-term threat to demographic stability.
The Situation in Gaza
In Gaza, the catastrophic impact 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 succumb from inadequate care, owing to desperate lacks of medicine and equipment. Agencies have reported women having children by the roadside because hospitals could not be reached.
“Direct shelling fired at the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or aiming to influence birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 childbirth centers have been attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births forced underground and skyrocketing stress leading to problems during delivery.
“Russia is targeting us deliberately,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The reality is, every facility is now a potential target,” states a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris could impact a hospital.”
Accountability Evaporates
For the over half a billion females living near active conflicts, there are few safeguards and even fewer war crimes prosecutions for those attacking childbirth services.
This lack of accountability has fostered a “atmosphere of lawlessness,” explains 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 rising sharply, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is restricted due to a communication blackout 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 faced detention, death, or harm 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 shatters health systems. Rights groups note that fear is now driving women away from facilities once considered safe, resulting in risky home births without skilled assistance.
“If maternity hospitals are being deliberately targeted points toward a wider and more disturbing trend: the use of violence against hospitals as a tool for terror and to break societal cohesion,” says a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘prejudicial to the opposing side’, which has often been cited as an excuse.”
