A group of thirty mothers were seeking shelter in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. Among them were new mothers, while others were actively in labor.
On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “I heard the screams of women and children,” he explains. “They executed everybody inside the hospital. Survival meant running for your life.”
This horrifying event stands as a particularly egregious examples in the protracted internal conflict tearing the North African nation apart. Armed soldiers forced their way into the building, allegedly slaughtering more than 460 patients and their companions.
Rights organizations have called it “an unspeakable atrocity,” and a clear case of the vanishing safeguards for civilians caught in conflict zones in multiple global hotspots.
An Unprecedented Assault On Childbirth Services
While all major powers have agreed to the international laws of war, which obligate them to protect civilians, the past year has experienced a historic high of attacks on healthcare systems. Expectant mothers are highly exposed due to their dependence on locally available medical care.
Research and compiled data 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 incidents do not represent natural consequences of war. They represent a pattern of reproductive violence.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where a vast number of women bearing children are confined.
Women have been killed, prevented from accessing care, or compelled to deliver in deplorable situations. The data also indicates that at least 68 maternal health workers have been murdered, 15 kidnapped, and 101 arrested—sometimes in the act of delivering babies.
The Global Crisis in Maternal Health
These figures likely represent 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 50% of women who lost their lives in maternal circumstances lived amidst hostilities. This underscores a horrifying trend.
Apart from fatalities, these attacks are obliterating hospitals and wards, creating a grave danger to societal repopulation and recovery.
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 declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children continue to die from inadequate care, owing to desperate lacks of medicine and equipment. Accounts describe women giving birth in rubble because hospitals were out of reach.
“Direct shelling hitting the wards, operating rooms, and maternity wards,” explains 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 attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births taking place in basements and extreme psychological pressure leading to birth complications.
“Russia is targeting us deliberately,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“The truth of the matter is, every facility is now a potential target,” notes a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris could impact a hospital.”
Accountability Evaporates
For the over half a billion females living close to deadly warfare, there are scarce guarantees and rare trials for atrocities for those assaulting reproductive health.
This void of justice has led to a “atmosphere of lawlessness,” says a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, may constitute acts of genocide by hindering reproduction.”
Other Conflict Zones
In El Fasher, the area lacked access to humanitarian aid long before the hospital attack, with malnutrition increasing drastically, 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, killing mothers, babies, and nurses.
In Myanmar, clinics have been attacked and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The End of Safe Deliveries
The majority of childbirth fatalities are preventable with routine care, but war shatters health systems. Rights groups note that fear is now driving women away from facilities once considered safe, pushing them toward risky home births without skilled assistance.
“The deliberate attack on maternity wards speaks to a broader and more sinister pattern: the use of attacks on medical facilities 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 increasingly been used as a justification.”
