A group of thirty mothers were seeking shelter in a maternity hospital in El Fasher, Sudan, as the slaughter began. Several had recently given birth, 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. “I heard the screams of women and children,” he states. “They were killing everyone inside the hospital. Survival meant running for your life.”
This brutal attack stands as among the worst examples in the ongoing war tearing the African nation apart. Militiamen forced their way into the building, leaving dead more than 460 innocent people inside.
Rights organizations have described it as “an unspeakable atrocity,” and a prime example of the collapse in safety for civilians trapped in war-torn areas in multiple global hotspots.
A Record of Violence On Childbirth Services
Despite every significant nation are signatories to the Geneva conventions, which commit them to defending civilians, the past year has seen a record number of violence targeting health services. Women undergoing childbirth are exceptionally vulnerable due to their reliance on locally available medical care.
Data analysis and investigations uncover an alarming level of violence: nearly 300 incidents targeting or hindering places and people associated with childbirth over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“This is not inevitable outcomes of conflict. They constitute a deliberate strategy of violence against reproduction.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where hundreds of thousands of expectant mothers are stranded.
Women have been killed, denied medical attention, or made to have their babies in deplorable situations. The data also indicates that at least 68 maternal health workers have been killed, 15 abducted, and 101 taken into custody—sometimes during medical procedures.
The Global Crisis in Maternal Health
The numbers are probably a substantial underreporting, as they capture solely incidents reported in news outlets. In many war-torn areas, reporting is limited.
Last year, it was reported that half of all women who lost their lives in maternal circumstances were in a conflict area. This underscores a devastating pattern.
Beyond killing women and staff, these attacks are wrecking hospitals and wards, posing a long-term threat to demographic stability.
The Situation in Gaza
In Gaza, the ruinous consequences on reproductive health rights has been cited by a UN commission as a factor in declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children continue to die from inadequate care, owing to critical shortages of medicine and equipment. Agencies have reported women delivering babies amidst ruins because hospitals could not be reached.
“We’ve had rockets targeting the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or seeking to affect birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been damaged or destroyed in Ukraine. Journalism from conflict zones describe births occurring in shelters and skyrocketing stress leading to birth complications.
“The attacks on us are intentional,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The reality is, 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.”
A Culture of Impunity
For the hundreds of millions of women living close to deadly warfare, there are scarce guarantees and even fewer war crimes prosecutions for those assaulting reproductive health.
This absence of consequences has fostered a “culture of impunity,” explains a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, may constitute acts of genocide by destroying a group's future.”
Additional Hotspots
In El Fasher, the area was isolated from 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, killing mothers, babies, and nurses.
In Myanmar, clinics have been attacked and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The Collapse of Safe Childbirth
Most maternal deaths are preventable with routine care, but war shatters health systems. Rights groups note that terror is compelling women away from facilities once considered safe, pushing them toward risky home births devoid of emergency care.
“If maternity hospitals are being deliberately targeted points toward 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 may forfeit their immunity if used for acts deemed ‘harmful to the enemy’, which has increasingly been used as a justification.”
