Thirty women had taken refuge in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Some had just delivered their newborns, while others were experiencing childbirth.
On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, became one of the few known survivors. “There were cries of women and children,” he explains. “A massacre was taking place inside the hospital. We who were able to escape, did so.”
This brutal attack stands as one of the most shocking examples in the ongoing war tearing the African nation apart. Militiamen stormed the facility, allegedly slaughtering more than 460 innocent people inside.
Rights organizations have described it as “an unspeakable atrocity,” and a clear case of the deteriorating protection for civilians living amidst warfare in multiple global hotspots.
An Unprecedented Assault On Childbirth Services
Although world powers are signatories to the international laws of war, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of assaults against medical infrastructure. Mothers in labor are highly exposed due to their need for locally available medical care.
Data analysis and investigations reveal an alarming level of violence: nearly 300 attacks on and disruptions to maternity care facilities, staff, and pregnant women over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“These incidents do not represent inevitable outcomes of conflict. They constitute a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where countless of women bearing children are confined.
Deaths have occurred, blocked from reaching help, or forced to give birth in dangerous and unsanitary conditions. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 abducted, and 101 detained—sometimes in the act of delivering babies.
A Worldwide Emergency for Mothers and Newborns
The numbers are probably a substantial underreporting, as they are limited to incidents reported in news outlets. In many war-torn areas, reporting is limited.
Last year, findings indicated that 50% of women who died during pregnancy or childbirth were in a conflict area. This underscores a catastrophic reality.
In addition to the loss of life, these attacks are obliterating maternal and neonatal care facilities, 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 declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children succumb from a lack of proper treatment, owing to severe deficits of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals were inaccessible.
“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 rejected deliberately targeting maternity care or trying to alter 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 extreme psychological pressure leading to birth complications.
“The attacks on us are intentional,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“In fact, every facility faces the threat of assault,” states 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 scarce guarantees and rare trials for atrocities for those attacking childbirth services.
This void of justice has created a “atmosphere of lawlessness,” says a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by destroying a group's future.”
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 scarce because of a lack of access from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, causing fatalities among patients and staff.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have suffered violence over the past two years of civil war.
The End of Safe Deliveries
A large proportion of mother deaths are avoidable with standard medicine, but war collapses medical infrastructure. Rights groups note that fear is now driving women away from facilities once considered safe, pushing them toward risky home births without skilled assistance.
“If maternity hospitals are being deliberately targeted indicates a larger and alarming strategy: the use of attacks on medical facilities as a tool for terror and to destroy community bonds,” observes 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 increasingly been used as a justification.”
