Thirty women had taken refuge in a maternity hospital 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, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “The sounds of screaming reached me of women and children,” he recounts. “They were killing everyone inside the hospital. Those who could run, fled.”
This horrifying event stands as a particularly egregious examples in the ongoing war tearing the North African nation apart. Militiamen stormed the facility, reportedly killing more than 460 patients and their companions.
Rights organizations have described it as “an unspeakable atrocity,” and a clear case of the vanishing safeguards for civilians living amidst warfare in multiple global hotspots.
An Unprecedented Assault On Childbirth Services
Despite every significant nation are signatories to the international laws of war, which commit them to defending civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Women undergoing childbirth are highly exposed due to their need for locally available medical care.
Research and compiled data show an shocking trend: nearly 300 attacks on and disruptions to maternity care facilities, staff, and pregnant women over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“This is not natural consequences of war. They form a pattern of reproductive violence.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where a vast number of expectant mothers are stranded.
Deaths have occurred, denied medical attention, or compelled to deliver in dangerous and unsanitary conditions. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 taken hostage, and 101 detained—sometimes in the act of delivering babies.
A Worldwide Emergency in Maternal Health
These figures likely represent a significant underestimate, as they capture solely incidents covered by the media. In many war-torn areas, communications are sparse.
Last year, it was reported that 50% of women who perished while pregnant or giving birth were in a conflict area. This underscores a catastrophic reality.
Beyond killing women and staff, these attacks are destroying critical infrastructure for mothers and babies, posing a long-term threat to societal repopulation and recovery.
The Situation in Gaza
In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as one reason behind declaring certain actions a genocide.
Following truces, doctors report that women and children succumb from inadequate care, owing to desperate lacks of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals could not be reached.
“We’ve had rockets fired at 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 damaged or destroyed in Ukraine. Accounts from embattled medical centers describe births forced underground and extreme psychological pressure leading to maternal health issues.
“We are being singled out,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“In fact, 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.”
A Culture of Impunity
For the more than 676 million women living close to deadly warfare, there are few safeguards and even fewer war crimes prosecutions for those assaulting reproductive health.
This void of justice has led to a “culture of impunity,” argues a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, may constitute acts of genocide by hindering reproduction.”
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 struck a baby care unit, causing fatalities among patients and staff.
In Myanmar, medical facilities have been bombed 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 destroys healthcare networks. Rights groups note that terror is compelling women away from facilities once considered safe, leading them to risky home births without skilled assistance.
“When childbirth centers become intentional targets indicates a wider and more disturbing trend: the use of attacks on medical facilities as a means of intimidation and to tear apart the social fabric,” 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 ‘prejudicial to the opposing side’, which has often been cited as an excuse.”
