A group of thirty mothers were huddled for safety in a childbirth facility in El Fasher, Sudan, as the slaughter began. Several had recently given birth, while others were experiencing childbirth.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “The sounds of screaming reached me of women and children,” he states. “They were killing everyone inside the hospital. Survival meant running for your life.”
This brutal attack stands as one of the most shocking examples in the protracted internal conflict tearing the North African nation apart. Militiamen raided the hospital, leaving dead more than 460 individuals receiving care and their families.
Rights organizations have labeled it “an act of unspeakable brutality,” and a prime example of the vanishing safeguards for civilians caught in conflict zones in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault On Childbirth Services
Although world powers have signed the Geneva conventions, which commit them to defending civilians, the past year has seen a record number of attacks on healthcare systems. Expectant mothers are particularly at risk due to their reliance on locally available medical care.
Data analysis and investigations uncover 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 are not inevitable outcomes of conflict. They represent a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where a vast number of expectant mothers are stranded.
Deaths have occurred, denied medical attention, or made to have their babies in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been murdered, 15 abducted, and 101 detained—sometimes while assisting births.
The Global Crisis for Mothers and Newborns
Statistics are thought to be a substantial underreporting, as they only include incidents covered by the media. In many war-torn areas, communications are sparse.
Last year, it was reported that half of all women who died during pregnancy or childbirth resided in a war zone. This underscores a horrifying trend.
Apart from fatalities, these attacks are obliterating critical infrastructure for mothers and babies, creating a grave danger to demographic stability.
Conditions within Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as one reason behind accusations of genocidal acts.
Following truces, doctors report that women and children succumb from a lack of proper treatment, owing to severe deficits of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals could not be reached.
“Our facility has endured missile strikes hitting the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or seeking to affect birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 childbirth centers have been struck and ruined in Ukraine. Accounts from embattled medical centers describe births forced underground and skyrocketing stress leading to problems during delivery.
“The attacks on us are intentional,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The reality is, every facility is now a potential target,” states 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 within range of fighting, there are minimal protections and a stark lack of legal accountability for those attacking childbirth services.
This absence of consequences has created a “culture of impunity,” argues a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, are potentially acts of genocide by destroying a group's future.”
Other Conflict Zones
In El Fasher, the area lacked access to 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 restricted due to a inability to report from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, killing mothers, babies, and nurses.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have faced detention, death, or harm over the past two years of civil war.
The End of Safe Deliveries
Most maternal deaths are avoidable with standard medicine, but war destroys healthcare networks. Rights groups note that anxiety is forcing 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 larger and alarming strategy: the use of attacks on medical facilities as a tool for terror and to destroy community bonds,” notes 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.”
