A group of thirty mothers had taken refuge in a maternity hospital in El Fasher, Sudan, as the slaughter began. Among them were new mothers, 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 recounts. “They executed everybody inside the hospital. We who were able to escape, did so.”
This horrifying event stands as one of the most shocking examples in the ongoing war tearing the North African nation apart. Combatants forced their way into the building, allegedly slaughtering more than 460 innocent people inside.
Rights organizations have labeled it “a crime beyond words,” and a clear case of the collapse in safety for civilians caught in conflict zones in multiple global hotspots.
A Record of Violence On Childbirth Services
While all major powers have signed the international laws of war, which commit them to defending civilians, the past year has witnessed an unprecedented spike of attacks on healthcare systems. Mothers in labor are exceptionally vulnerable due to their need for locally available medical care.
Research and compiled data show an alarming level of violence: nearly 300 incidents targeting or hindering maternity care facilities, staff, and pregnant women over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“These incidents do not represent natural consequences of war. They represent a systematic assault on childbirth.”
The majority of these incidents have happened in regions embroiled in intense conflict, where a vast number of expectant mothers are stranded.
Women have been killed, denied medical attention, or made to have their babies in deplorable situations. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 kidnapped, and 101 detained—sometimes in the act of delivering babies.
A Worldwide Emergency in Maternal Health
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, findings indicated that 50% of women who died during pregnancy or childbirth resided in a war zone. This underscores a devastating pattern.
Beyond killing women and staff, these attacks are destroying maternal and neonatal care facilities, posing a long-term threat to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as one reason behind accusations of genocidal acts.
Following truces, doctors report that women and children continue to die from medical shortages, owing to critical shortages of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals were inaccessible.
“Direct shelling targeting 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 trying to alter birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been struck and ruined in Ukraine. Journalism from conflict zones describe births occurring in shelters and skyrocketing stress leading to maternal health issues.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The reality is, every facility faces the threat of assault,” comments 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 within range of fighting, there are minimal protections and a stark lack of legal accountability for those attacking childbirth services.
This lack of accountability has fostered a “environment where anything goes,” argues a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, can be understood as acts of genocide by preventing births.”
Other Conflict Zones
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 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, 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 averted with basic healthcare, but war collapses medical infrastructure. Rights groups note that anxiety is forcing women away from facilities once considered safe, pushing them toward risky home births lacking professional help.
“If maternity hospitals are being deliberately targeted points toward a larger and alarming strategy: the use of attacks on medical facilities as a weapon to spread fear and to break societal cohesion,” notes 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 ‘harmful to the enemy’, which has increasingly been used as a justification.”
