A group of thirty mothers had taken refuge in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Among them were new mothers, while others were actively in labor.
On duty during that fateful 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 recounts. “They executed everybody inside the hospital. Those who could run, fled.”
This brutal attack stands as one of the most shocking examples in the two-year civil war tearing the North African nation apart. Militiamen forced their way into the building, allegedly slaughtering more than 460 innocent people inside.
Rights organizations have called it “a crime beyond words,” and a clear case of the deteriorating protection for civilians trapped in war-torn areas in several nations at war.
A Record of Violence Against Maternal Care
Although world powers have signed the international laws of war, which commit them to defending civilians, the past year has experienced a historic high of attacks on healthcare systems. Expectant mothers are exceptionally vulnerable due to their need for locally available medical care.
An investigation of records show 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 inevitable outcomes of conflict. They form a pattern of reproductive violence.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where hundreds of thousands of pregnant women are trapped.
Deaths have occurred, prevented from accessing care, or made to have their babies in deplorable situations. The data also indicates that at least 68 maternal health workers have been murdered, 15 taken hostage, and 101 taken into custody—sometimes while assisting births.
The Global Crisis for Mothers and Newborns
Statistics are thought to be a substantial underreporting, as they capture solely incidents documented publicly. In many areas of fighting, reporting is limited.
Last year, findings indicated that one in two mothers who perished while pregnant or giving birth were in a conflict area. This underscores a horrifying trend.
Beyond killing women and staff, these attacks are obliterating maternal and neonatal care facilities, posing a long-term threat to community survival.
The Situation in Gaza
In Gaza, the ruinous consequences on the right to maternal care 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 are still perishing from inadequate care, owing to severe deficits of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals were out of reach.
“We’ve had rockets fired at 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 struck and ruined in Ukraine. Reports from frontline hospitals describe births forced underground and skyrocketing stress leading to birth complications.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The reality is, every facility can be under attack now,” notes a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris can strike a hospital.”
Accountability Evaporates
For the more than 676 million women living near active conflicts, there are minimal protections and even fewer war crimes prosecutions for those targeting maternity care.
This absence of consequences has fostered a “atmosphere of lawlessness,” explains a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by preventing births.”
Other Conflict Zones
In El Fasher, the area was isolated from 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 scarce because of a communication blackout from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, killing mothers, babies, and nurses.
In Myanmar, hospitals have come under fire 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 collapses medical infrastructure. Rights groups note that anxiety is forcing women away from facilities once considered safe, pushing them toward risky home births lacking professional help.
“When childbirth centers become intentional targets speaks to a wider and more disturbing trend: the use of violence against hospitals as a weapon to spread fear and to destroy community bonds,” notes 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 now become a standard defence.”
