A group of thirty mothers were seeking shelter in a maternity hospital in El Fasher, Sudan, when the massacre started. Several had recently given birth, while others were experiencing childbirth.
Working that 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. “They executed everybody inside the hospital. Survival meant running for your life.”
This appalling incident stands as one of the most shocking examples in the protracted internal conflict tearing the North African nation apart. Combatants stormed the facility, allegedly slaughtering more than 460 individuals receiving care and their families.
Rights organizations have described it as “a crime beyond words,” and a stark illustration of the deteriorating protection for civilians caught in conflict zones in multiple global hotspots.
An Unprecedented Assault On Childbirth Services
While all major powers have agreed to the international laws of war, which commit them to defending civilians, the past year has witnessed an unprecedented spike of attacks on healthcare systems. Women undergoing childbirth are particularly at risk due to their dependence on locally available medical care.
An investigation of records show 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 assaults have occurred in regions embroiled in intense conflict, where a vast number of pregnant women are trapped.
Women have been killed, denied medical attention, or compelled to deliver in deplorable situations. The data also indicates that at least 68 maternal health workers have been slain, 15 kidnapped, and 101 taken into custody—sometimes in the act of delivering babies.
The Global Crisis for Mothers and Newborns
These figures likely represent a substantial underreporting, as they only include incidents reported in news outlets. In many war-torn areas, communications are sparse.
Last year, findings indicated that 50% of women who lost their lives in maternal circumstances lived amidst hostilities. This underscores a catastrophic reality.
In addition to the loss of life, these attacks are wrecking hospitals and wards, posing a long-term threat to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the catastrophic impact on reproductive health rights has been cited by a UN commission as a factor in declaring certain actions a genocide.
Following truces, doctors report that women and children continue to die from a lack of proper treatment, owing to desperate lacks of medicine and equipment. Agencies have reported women having children by the roadside because hospitals were out of reach.
“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 rejected deliberately targeting maternity care or seeking to affect birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 hospitals for mothers and babies have been damaged or destroyed in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and extreme psychological pressure leading to maternal health issues.
“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 truth of the matter is, every facility is now a potential target,” notes a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris could impact a hospital.”
Accountability Evaporates
For the hundreds of millions of women living near active conflicts, there are few safeguards and rare trials for atrocities for those targeting maternity care.
This lack of accountability has fostered a “environment where anything goes,” explains a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, are potentially acts of genocide by hindering reproduction.”
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 scarce because of a lack of access from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, causing fatalities among patients and staff.
In Myanmar, clinics have been attacked 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
A large proportion of mother deaths are avoidable with standard medicine, but war shatters health systems. Rights groups note that fear is now driving women away from facilities once considered safe, resulting in risky home births lacking professional help.
“The deliberate attack on maternity wards speaks to a broader and more sinister pattern: the use of attacks on medical facilities as a tool for terror and to tear apart the social fabric,” observes a legal researcher.
“There is no absolute protection 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 now become a standard defence.”
