A group of thirty mothers were huddled for safety in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. 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, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “I heard the screams of women and children,” he explains. “They executed everybody inside the hospital. Those who could run, fled.”
This horrifying event stands as among the worst examples in the two-year civil war tearing the African nation apart. Militiamen raided the hospital, reportedly killing more than 460 innocent people inside.
Rights organizations have called it “a crime beyond words,” and a clear case of the deteriorating protection for civilians trapped in war-torn areas in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault Against Maternal Care
Although world powers are signatories to the Geneva conventions, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of assaults against medical infrastructure. Mothers in labor are exceptionally vulnerable due to their dependence on locally available medical care.
An investigation of records reveal an unprecedented scale of attacks: nearly 300 incidents targeting or hindering maternity care facilities, staff, and pregnant women over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These are not 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.
Deaths have occurred, blocked from reaching help, or made to have their babies in deplorable situations. The data also indicates that at least 68 maternal health workers have been killed, 15 abducted, and 101 arrested—sometimes while assisting births.
A Worldwide Emergency in Maternal Health
These figures likely represent a substantial underreporting, as they only include incidents reported in news outlets. In many conflict zones, communications are sparse.
Last year, findings indicated that 50% of women who lost their lives in maternal circumstances were in a conflict area. This underscores a devastating pattern.
In addition to the loss of life, these attacks are wrecking critical infrastructure for mothers and babies, posing a long-term threat to community survival.
The Situation in Gaza
In Gaza, the catastrophic impact on reproductive health rights has been cited by a UN commission as one reason behind genocide allegations.
Even after ceasefires, doctors report that women and children succumb from medical shortages, owing to desperate lacks of medicine and equipment. Accounts describe women giving birth in rubble because hospitals could not be reached.
“We’ve had rockets 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.
Ukraine's Ordeal
Since early 2022, at least 80 childbirth centers have been damaged or destroyed in Ukraine. Journalism from conflict zones describe births taking place in basements and skyrocketing stress leading to maternal health issues.
“Russia is targeting us deliberately,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The reality is, every facility can be under attack now,” states a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris may hit a hospital.”
A Culture of Impunity
For the more than 676 million women living within range of fighting, there are minimal protections and rare trials for atrocities for those attacking childbirth services.
This absence of consequences has created a “atmosphere of lawlessness,” argues a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, are potentially acts of genocide by preventing births.”
Additional Hotspots
In El Fasher, the area had been cut off 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 limited by a inability to report from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, causing fatalities among patients and staff.
In Myanmar, clinics have been attacked and dozens of midwives and patients have suffered violence over the past two years of civil war.
The End of Safe Deliveries
Most maternal deaths are avoidable with standard medicine, but war collapses medical infrastructure. Rights groups note that terror is compelling women away from facilities once considered safe, leading them to risky home births without skilled assistance.
“When childbirth centers become intentional targets speaks to a larger and alarming strategy: the use of attacks on medical facilities as a weapon to spread fear and to break societal cohesion,” says a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”
