A group of thirty mothers had taken refuge 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. “There were cries of women and children,” he recounts. “They executed everybody inside the hospital. Survival meant running for your life.”
This horrifying event stands as one of the most shocking examples in the protracted internal conflict tearing the North African nation apart. Militiamen stormed the facility, leaving dead more than 460 individuals receiving care and their families.
Rights organizations have labeled it “an unspeakable atrocity,” and a stark illustration of the deteriorating protection for civilians caught in conflict zones in several nations at war.
A Record of Violence Against Maternal Care
While all major powers have signed the international laws of war, which commit them to defending civilians, the past year has seen a record number of attacks on healthcare systems. Expectant mothers are highly exposed due to their dependence on locally available medical care.
Data analysis and investigations show an unprecedented scale of attacks: nearly 300 incidents targeting or hindering places and people associated with childbirth over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“This is not inevitable outcomes of conflict. They constitute a systematic assault on childbirth.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where a vast number of pregnant women are trapped.
Women have been killed, prevented from accessing care, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 abducted, and 101 arrested—sometimes while assisting births.
A Worldwide Emergency in Maternal Health
The numbers are probably a grave undercount, as they only include incidents reported in news outlets. In many war-torn areas, reporting is limited.
Last year, findings indicated that half of all women who lost their lives in maternal circumstances resided in a war zone. This underscores a horrifying trend.
Beyond killing women and staff, these attacks are obliterating hospitals and wards, jeopardizing the future to community survival.
The Situation in Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as a factor in genocide allegations.
Following truces, doctors report that women and children continue to die from inadequate care, owing to critical shortages of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals were out of reach.
“Direct shelling hitting 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 trying to alter birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 hospitals for mothers and babies have been struck and ruined in Ukraine. Reports from frontline hospitals 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. The government has disputed deliberately targeting civilians.
“The reality is, every facility can be under attack now,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”
Accountability Evaporates
For the hundreds of millions of women living near active conflicts, there are few safeguards and a stark lack of legal accountability for those targeting maternity care.
This absence of consequences has led to a “atmosphere of lawlessness,” explains a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, may constitute acts of genocide by destroying a group's future.”
Additional Hotspots
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 scarce because of 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 been arrested, killed, or injured over the past two years of civil war.
The End of Safe Deliveries
The majority of childbirth fatalities are preventable with routine care, 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 lacking professional help.
“The deliberate attack on maternity wards points toward a larger and alarming strategy: the use of violence against hospitals as a means of intimidation and to tear apart the social fabric,” says a legal researcher.
“There is no absolute protection 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.”
