A group of thirty mothers were huddled for safety in a maternity hospital in El Fasher, Sudan, when the massacre started. Several had recently given birth, 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. “The sounds of screaming reached me of women and children,” he states. “They were killing everyone inside the hospital. Those who could run, fled.”
This horrifying event stands as a particularly egregious examples in the two-year civil war tearing the African nation apart. Combatants forced their way into the building, allegedly slaughtering more than 460 individuals receiving care and their families.
Rights organizations have called it “an unspeakable atrocity,” and a stark illustration of the deteriorating protection for civilians living amidst warfare in several nations at war.
A Record of Violence Against Maternal Care
While all major 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. Expectant mothers are highly exposed due to their need for locally available medical care.
Data analysis and investigations reveal an alarming level of violence: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“These are not inevitable outcomes of conflict. They represent a pattern of reproductive violence.”
The majority of these incidents have happened in regions embroiled in intense conflict, where hundreds of thousands of women bearing children are confined.
Deaths have occurred, blocked from reaching help, or forced to give birth in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 kidnapped, and 101 detained—sometimes in the act of delivering babies.
The Global Crisis for Mothers and Newborns
Statistics are thought to be a grave undercount, as they capture solely incidents reported in news outlets. In many conflict zones, communications are sparse.
Last year, it was reported that one in two mothers who perished while pregnant or giving birth lived amidst hostilities. This underscores a horrifying trend.
Apart from fatalities, 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 reproductive health rights has been cited by a UN commission as part of the basis for accusations of genocidal acts.
Even after ceasefires, doctors report that women and children are still perishing from a lack of proper treatment, owing to critical shortages of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals could not be reached.
“We’ve had rockets 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 struck and ruined in Ukraine. Reports from frontline hospitals describe births taking place in basements and skyrocketing stress leading to problems during delivery.
“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 truth of the matter is, every facility can be under attack now,” comments a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”
A Culture of Impunity
For the more than 676 million women living near active conflicts, there are minimal protections and even fewer war crimes prosecutions for those attacking childbirth services.
This lack of accountability has led to a “atmosphere of lawlessness,” explains a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, can be understood as acts of genocide by destroying a group's future.”
Other Conflict Zones
In El Fasher, the area had been cut off from 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 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, hospitals have come under fire and dozens of midwives and patients have suffered violence over the past two years of civil war.
The Collapse of Safe Childbirth
The majority of childbirth fatalities are avoidable with standard medicine, but war shatters health systems. Rights groups note that terror is compelling women away from facilities once considered safe, pushing them toward risky home births lacking professional help.
“The deliberate attack on maternity wards speaks to a larger and alarming strategy: the use of violence against hospitals as a means of intimidation and to break societal cohesion,” says a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”
