Thirty women were seeking shelter in a maternity hospital in El Fasher, Sudan, as the slaughter began. Some had just delivered their newborns, while others were in the midst of labor.
On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “There were cries of women and children,” he explains. “They were killing everyone inside the hospital. Survival meant running for your life.”
This appalling incident stands as among the worst examples in the ongoing war tearing the African nation apart. Armed soldiers raided the hospital, allegedly slaughtering more than 460 individuals receiving care and their families.
Rights organizations have described it as “an unspeakable atrocity,” and a stark illustration of the collapse in safety for civilians caught in conflict zones in multiple global hotspots.
An Unprecedented Assault Against Maternal Care
Although world powers have agreed to the Geneva conventions, which commit them to defending civilians, the past year has seen a record number of assaults against medical infrastructure. Mothers in labor are particularly at risk due to their reliance on locally available medical care.
Research and compiled data uncover an unprecedented scale of attacks: nearly 300 violent acts against places and people associated with childbirth 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 systematic assault on childbirth.”
The majority of these incidents have happened in regions embroiled in intense conflict, where hundreds of thousands of expectant mothers are stranded.
Mothers have lost their lives, prevented from accessing care, or made to have their babies in dangerous and unsanitary conditions. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 kidnapped, and 101 detained—sometimes while assisting births.
The Global Crisis in Maternal Health
The numbers are probably a grave undercount, as they capture solely incidents reported in news outlets. In many conflict zones, communications are sparse.
Last year, it was reported that one in two mothers who lost their lives in maternal circumstances were in a conflict area. This underscores a catastrophic reality.
Apart from fatalities, these attacks are wrecking hospitals and wards, posing a long-term threat to community survival.
Conditions within Gaza
In Gaza, the catastrophic impact on reproductive health rights has been cited by a UN commission as part of the basis for genocide allegations.
Following truces, doctors report that women and children are still perishing from medical shortages, owing to critical shortages of medicine and equipment. Accounts describe women having children by the roadside because hospitals were out of reach.
“Direct shelling fired at the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has rejected 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.
“The attacks on us are intentional,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied 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 can strike a hospital.”
A Culture of Impunity
For the more than 676 million women living near active conflicts, there are scarce guarantees and even fewer war crimes prosecutions for those attacking childbirth services.
This absence of consequences has created a “atmosphere of lawlessness,” explains a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, may constitute acts of genocide by destroying a group's future.”
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 scarce because of a inability to report from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, killing mothers, babies, and nurses.
In Myanmar, clinics have been attacked and dozens of midwives and patients have faced detention, death, or harm over the past two years of civil war.
The End of Safe Deliveries
Most maternal deaths are avoidable with standard medicine, but war collapses medical infrastructure. Rights groups note that anxiety is forcing women away from facilities once considered safe, resulting in risky home births without skilled assistance.
“When childbirth centers become intentional targets speaks to a wider and more disturbing trend: the use of violence against hospitals as a means of intimidation and to destroy community bonds,” says a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”
