A group of thirty mothers were huddled for safety in a childbirth facility in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, while others were actively in labor.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “I heard the screams of women and children,” he explains. “They were killing everyone inside the hospital. Survival meant running for your life.”
This brutal attack stands as one of the most shocking examples in the two-year civil war tearing the North African nation apart. Combatants stormed the facility, allegedly slaughtering more than 460 patients and their companions.
Rights organizations have described it as “a crime beyond words,” and a stark illustration of the vanishing safeguards for civilians living amidst warfare in multiple global hotspots.
An Unprecedented Assault Against Maternal Care
Although world powers have signed the international laws of war, which require them to safeguard civilians, the past year has seen a record number of assaults against medical infrastructure. Mothers in labor are exceptionally vulnerable due to their need for locally available medical care.
An investigation of records show an unprecedented scale of attacks: nearly 300 incidents targeting or hindering maternity care facilities, staff, and pregnant women over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“These incidents do not represent natural consequences of war. They constitute a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where a vast number of expectant mothers are stranded.
Mothers have lost their lives, prevented from accessing care, or compelled to deliver in dangerous and unsanitary conditions. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 taken hostage, and 101 taken into custody—sometimes during medical procedures.
A Worldwide Emergency for Mothers and Newborns
Statistics are thought to be a substantial underreporting, as they capture solely incidents reported in news outlets. In many conflict zones, information is scarce.
Last year, findings indicated that half of all women who perished while pregnant or giving birth resided in a war zone. This underscores a horrifying trend.
Beyond killing women and staff, these attacks are obliterating critical infrastructure for mothers and babies, jeopardizing the future to demographic stability.
The Situation in Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as one reason behind genocide allegations.
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 having children by the roadside because hospitals were inaccessible.
“Our facility has endured missile strikes fired at 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 trying to alter birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities have been struck and ruined in Ukraine. Accounts from embattled medical centers describe births taking place in basements and extreme psychological pressure leading to problems during delivery.
“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 faces the threat of assault,” comments 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 within range of fighting, there are minimal protections and rare trials for atrocities for those attacking childbirth services.
This lack of accountability has led to a “environment where anything goes,” argues a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, may constitute acts of genocide by preventing births.”
Other Conflict Zones
In El Fasher, the area had been cut off 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 restricted due to a inability to report from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, killing mothers, babies, and nurses.
In Myanmar, medical facilities have been bombed 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
A large proportion of mother deaths are avoidable with standard medicine, but war collapses medical infrastructure. Rights groups note that terror is compelling women away from facilities once considered safe, resulting in risky home births without skilled assistance.
“If maternity hospitals are being deliberately targeted points toward a wider and more disturbing trend: the use of attacks on medical facilities as a tool for terror and to break societal cohesion,” observes a legal researcher.
“There is no absolute protection 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.”
