A group of thirty mothers had taken refuge in a maternity hospital in El Fasher, Sudan, as the slaughter began. 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. “I heard the screams of women and children,” he recounts. “They executed everybody inside the hospital. Survival meant running for your life.”
This appalling incident stands as a particularly egregious examples in the ongoing war tearing the North African nation apart. Armed soldiers stormed the facility, allegedly slaughtering more than 460 innocent people inside.
Rights organizations have called it “an unspeakable atrocity,” and a stark illustration of the vanishing safeguards for civilians caught in conflict zones in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence Against Maternal Care
Despite every significant nation have signed the international laws of war, which require them to safeguard civilians, the past year has experienced a historic high of violence targeting health services. Expectant mothers are particularly at risk due to their need for locally available medical care.
Research and compiled data show 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 direct strikes on hospitals and delivery wards.
“This is not natural consequences of war. They constitute a deliberate strategy of violence against reproduction.”
The majority of these incidents have happened in regions embroiled in intense conflict, where countless of pregnant women are trapped.
Mothers have lost their lives, blocked from reaching help, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 abducted, and 101 taken into custody—sometimes while assisting births.
The Global Crisis for Mothers and Newborns
These figures likely represent a substantial underreporting, as they capture solely 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 were in a conflict area. This underscores a catastrophic reality.
In addition to the loss of life, these attacks are obliterating critical infrastructure for mothers and babies, posing a long-term threat 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 a factor in accusations of genocidal acts.
Despite periods of calm, doctors report that women and children continue to die from inadequate care, owing to desperate lacks of medicine and equipment. Agencies have reported women having children by the roadside because hospitals could not be reached.
“Direct shelling targeting the wards, operating rooms, and maternity wards,” explains 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 childbirth centers have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births taking place in basements and extreme psychological pressure leading to problems during delivery.
“We are being singled out,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The reality is, every facility is now a potential target,” comments a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris could impact a hospital.”
A Culture of Impunity
For the over half a billion females living close to deadly warfare, there are minimal protections and a stark lack of legal accountability for those targeting maternity care.
This absence of consequences has led to a “environment where anything goes,” argues a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, may constitute acts of genocide by preventing births.”
Additional Hotspots
In El Fasher, the area lacked access to 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 limited by a inability to report from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, resulting in tragic loss of life.
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
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 devoid of emergency care.
“When childbirth centers become intentional targets indicates a larger and alarming strategy: the use of violence against hospitals as a tool for terror and to break societal cohesion,” says a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”
