Thirty women were seeking shelter 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, a technician named 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. We who were able to escape, did so.”
This appalling incident stands as a particularly egregious examples in the two-year civil war tearing the North African nation apart. Armed soldiers forced their way into the building, allegedly slaughtering more than 460 innocent people inside.
Rights organizations have called it “an act of unspeakable brutality,” and a clear case of the collapse in safety for civilians caught in conflict zones in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence On Childbirth Services
While all major powers are signatories to the Geneva conventions, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of assaults against medical infrastructure. Mothers in labor are highly exposed due to their reliance on locally available medical care.
An investigation of records uncover an unprecedented scale of attacks: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These are not natural consequences of war. They constitute a pattern of reproductive violence.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where a vast number of women bearing children are confined.
Mothers have lost their lives, blocked from reaching help, or made to have their babies in deplorable situations. The data also indicates that at least 68 maternal health workers have been slain, 15 kidnapped, and 101 taken into custody—sometimes during medical procedures.
A Worldwide Emergency for Mothers and Newborns
These figures likely represent a grave undercount, as they are limited to incidents covered by the media. In many war-torn areas, communications are sparse.
Last year, analysis showed that 50% of women who lost their lives in maternal circumstances resided in a war zone. This underscores a catastrophic reality.
Apart from fatalities, these attacks are destroying critical infrastructure for mothers and babies, jeopardizing the future to community survival.
The Situation in 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 continue to die from inadequate care, owing to severe deficits of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals were out of reach.
“We’ve had rockets targeting 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.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities have been damaged or destroyed in Ukraine. Reports from frontline hospitals describe births forced underground and extreme psychological pressure leading to problems during delivery.
“The attacks on us are intentional,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“In fact, every facility faces the threat of assault,” states a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris may hit a hospital.”
Accountability Evaporates
For the over half a billion females living within range of fighting, there are scarce guarantees and rare trials for atrocities for those targeting maternity care.
This void of justice has led to a “atmosphere of lawlessness,” argues a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, can be understood as acts of genocide by hindering reproduction.”
Additional Hotspots
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 limited by a lack of access from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, resulting in tragic loss of life.
In Myanmar, clinics have been attacked and dozens of midwives and patients have suffered violence over the past two years of civil war.
The Collapse of Safe Childbirth
The majority of childbirth fatalities 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 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 tool for terror and to destroy community bonds,” says 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 ‘harmful to the enemy’, which has often been cited as an excuse.”
