Thirty women had taken refuge in a childbirth facility in El Fasher, Sudan, as the slaughter began. Among them were new mothers, while others were actively in labor.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “There were cries of women and children,” he explains. “They executed everybody inside the hospital. Survival meant running for your life.”
This horrifying event stands as among the worst examples in the protracted internal conflict tearing the African nation apart. Armed soldiers raided the hospital, reportedly killing more than 460 innocent people inside.
Rights organizations have labeled it “an unspeakable atrocity,” and a clear case of the deteriorating protection for civilians trapped in war-torn areas in multiple global hotspots.
A Record of Violence Against Maternal Care
While all major powers are signatories to the Geneva conventions, which require them to safeguard civilians, the past year has seen a record number of attacks on healthcare systems. Mothers in labor are highly exposed due to their need for locally available medical care.
An investigation of records show an shocking trend: nearly 300 incidents targeting or hindering 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 constitute a systematic assault on childbirth.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where a vast number of pregnant women are trapped.
Mothers have lost their lives, denied medical attention, or forced to give birth in deplorable situations. The data also indicates that at least 68 maternal health workers have been slain, 15 kidnapped, and 101 arrested—sometimes in the act of delivering babies.
A Worldwide Emergency in Maternal Health
Statistics are thought to be a significant underestimate, as they capture solely incidents reported in news outlets. In many war-torn areas, communications are sparse.
Last year, analysis showed that half of all women who died during pregnancy or childbirth were in a conflict area. This underscores a catastrophic reality.
Beyond killing women and staff, these attacks are destroying maternal and neonatal care facilities, creating a grave danger to community survival.
Conditions within Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as part of the basis for declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children succumb from inadequate care, owing to severe deficits of medicine and equipment. Accounts describe women having children by the roadside because hospitals were out of reach.
“We’ve had rockets fired at the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or aiming to influence birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been attacked and rendered unusable in Ukraine. Reports from frontline hospitals describe births occurring in shelters and extreme psychological pressure leading to birth complications.
“Russia is targeting us deliberately,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The truth of the matter is, every facility is now a potential target,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris could impact a hospital.”
A Culture of Impunity
For the more than 676 million women living close to deadly warfare, there are minimal protections and rare trials for atrocities for those attacking childbirth services.
This absence of consequences has fostered a “culture of impunity,” explains a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, can be understood as 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 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 struck a baby care unit, causing fatalities among patients and staff.
In Myanmar, hospitals have come under fire 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
Most maternal deaths are avoidable with standard medicine, but war shatters health systems. Rights groups note that fear is now driving women away from facilities once considered safe, resulting in risky home births lacking professional help.
“When childbirth centers become intentional targets points toward a wider and more disturbing trend: the use of attacks on medical facilities as a means of intimidation and to break societal cohesion,” notes a legal researcher.
“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has increasingly been used as a justification.”
