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 experiencing childbirth.
On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “I heard the screams of women and children,” he recounts. “They were killing everyone inside the hospital. Survival meant running for your life.”
This appalling incident stands as among the worst examples in the protracted internal conflict tearing the North African nation apart. Militiamen stormed the facility, allegedly slaughtering more than 460 innocent people inside.
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 multiple global hotspots.
A Record of Violence Against Maternal Care
Although world powers have signed the Geneva conventions, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of attacks on healthcare systems. Mothers in labor are highly exposed due to their dependence on locally available medical care.
Research and compiled data show an unprecedented scale of attacks: 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 constitute a systematic assault on childbirth.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where countless of women bearing children are confined.
Women have been killed, prevented from accessing care, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 kidnapped, and 101 taken into custody—sometimes in the act of delivering babies.
The Global Crisis for Mothers and Newborns
These figures likely represent a grave undercount, as they are limited to incidents reported in news outlets. In many conflict zones, reporting is limited.
Last year, it was reported that half of all women who lost their lives in maternal circumstances were in a conflict area. This underscores a horrifying trend.
In addition to the loss of life, these attacks are obliterating critical infrastructure for mothers and babies, posing a long-term threat to community survival.
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 genocide allegations.
Despite periods of calm, doctors report that women and children are still perishing from a lack of proper treatment, owing to severe deficits of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals could not be reached.
“Direct shelling hitting the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or aiming to influence birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 childbirth centers have been attacked and rendered unusable in Ukraine. Reports from frontline hospitals describe births occurring in shelters and extreme psychological pressure leading to birth complications.
“Russia is targeting us deliberately,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The reality is, every facility faces the threat of assault,” notes a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris can strike a hospital.”
A Culture of Impunity
For the over half a billion females living within range of fighting, there are scarce guarantees and a stark lack of legal accountability for those attacking childbirth services.
This lack of accountability has created a “atmosphere of lawlessness,” argues a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, 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 spiking dangerously, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is restricted due to a inability to report from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, resulting in tragic loss of life.
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
Most maternal deaths are averted with basic healthcare, but war collapses medical infrastructure. Rights groups note that fear is now driving 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 wider and more disturbing trend: the use of attacks on medical facilities 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 ‘harmful to the enemy’, which has often been cited as an excuse.”
