A group of thirty mothers were seeking shelter in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Some had just delivered their newborns, while others were actively in labor.
On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “The sounds of screaming reached me of women and children,” he states. “A massacre was taking place inside the hospital. Those who could run, fled.”
This horrifying event stands as one of the most shocking examples in the protracted internal conflict tearing the North African nation apart. Militiamen raided the hospital, reportedly killing more than 460 patients and their companions.
Rights organizations have labeled it “an unspeakable atrocity,” and a clear case of the vanishing safeguards for civilians living amidst warfare in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault On Childbirth Services
While all major powers have signed the Geneva conventions, which require them to safeguard civilians, the past year has experienced a historic high of violence targeting health services. Expectant mothers are exceptionally vulnerable due to their reliance on locally available medical care.
Research and compiled data reveal an shocking trend: nearly 300 violent acts against places and people associated with childbirth over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These are not standard wartime hazards. They constitute a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where countless of expectant mothers are stranded.
Mothers have lost their lives, blocked from reaching help, or made to have their babies in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 taken hostage, and 101 detained—sometimes while assisting births.
A Worldwide Emergency for Mothers and Newborns
These figures likely represent a significant underestimate, as they only include incidents covered by the media. In many war-torn areas, reporting is limited.
Last year, it was reported that one in two mothers who lost their lives in maternal circumstances lived amidst hostilities. This underscores a devastating pattern.
Apart from fatalities, these attacks are destroying maternal and neonatal care facilities, jeopardizing the future to societal repopulation and recovery.
The Situation in Gaza
In Gaza, the ruinous consequences on reproductive health rights has been cited by a UN commission as one reason behind accusations of genocidal acts.
Even after ceasefires, doctors report that women and children succumb from inadequate care, owing to desperate lacks of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals were out of reach.
“Direct shelling hitting the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or aiming to influence 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 occurring in shelters and skyrocketing stress leading to birth complications.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied 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 can strike a hospital.”
Accountability Evaporates
For the hundreds of millions of women living close to deadly warfare, there are minimal protections and a stark lack of legal accountability for those assaulting reproductive health.
This absence of consequences has created a “culture of impunity,” explains a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, may constitute acts of genocide by preventing births.”
Additional Hotspots
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 limited by a lack of access from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, causing fatalities among patients and staff.
In Myanmar, hospitals have come under fire and dozens of midwives and patients have faced detention, death, or harm 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, leading them to risky home births lacking professional help.
“The deliberate attack on maternity wards speaks to a larger and alarming strategy: the use of violence against hospitals as a weapon to spread fear and to break societal cohesion,” observes a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”
