A group of thirty mothers were huddled for safety in a maternity hospital 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, Abdo-Rabo Ahmed, became one of the few known survivors. “There were cries of women and children,” he recounts. “They were killing everyone 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. Armed soldiers stormed the facility, reportedly killing more than 460 individuals receiving care and their families.
Rights organizations have called it “a crime beyond words,” and a stark illustration of the deteriorating protection for civilians living amidst warfare in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence Against Maternal Care
Despite every significant nation have agreed to the international laws of war, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of assaults against medical infrastructure. Women undergoing childbirth are highly exposed due to their reliance on locally available medical care.
An investigation of records show an alarming level of violence: 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 incidents do not represent standard wartime hazards. They constitute a systematic assault on childbirth.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where countless of expectant mothers are stranded.
Women have been killed, prevented from accessing care, or forced to give birth in deplorable situations. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 kidnapped, and 101 detained—sometimes during medical procedures.
A Worldwide Emergency for Mothers and Newborns
These figures likely represent a substantial underreporting, as they capture solely incidents reported in news outlets. In many conflict zones, information is scarce.
Last year, it was reported that one in two mothers who perished while pregnant or giving birth resided in a war zone. This underscores a devastating pattern.
In addition to the loss of life, these attacks are wrecking 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 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 severe deficits of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals were out of reach.
“We’ve had rockets targeting 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 aiming to influence birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 hospitals for mothers and babies have been struck and ruined in Ukraine. Journalism from conflict zones describe births taking place in basements and extreme psychological pressure leading to problems during delivery.
“We are being singled out,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“In fact, every facility faces the threat of assault,” states a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris could impact a hospital.”
Accountability Evaporates
For the more than 676 million women living within range of fighting, there are scarce guarantees and even fewer war crimes prosecutions for those assaulting reproductive health.
This lack of accountability has created a “environment where anything goes,” explains a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, 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 increasing drastically, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is restricted due to a lack of access from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, resulting in tragic loss of life.
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 lacking professional help.
“If maternity hospitals are being deliberately targeted indicates a broader and more sinister pattern: the use of violence against hospitals as a tool for terror and to tear apart the social fabric,” notes a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘harmful to the enemy’, which has often been cited as an excuse.”
