Dozens of women were seeking shelter in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Among them were new mothers, while others were in the midst of labor.
On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “The sounds of screaming reached me of women and children,” he explains. “They were killing everyone inside the hospital. Survival meant running for your life.”
This brutal attack stands as among the worst examples in the ongoing war tearing the North African nation apart. Combatants forced their way into the building, allegedly slaughtering more than 460 individuals receiving care and their families.
Rights organizations have labeled it “an unspeakable atrocity,” and a clear case of the collapse in safety for civilians caught in conflict zones in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence On Childbirth Services
While all major powers have signed the Geneva conventions, which commit them to defending 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.
An investigation of records reveal an alarming level of violence: 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 inevitable outcomes of conflict. They form a deliberate strategy of violence against reproduction.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where countless of expectant mothers are stranded.
Deaths have occurred, prevented from accessing care, 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 during medical procedures.
A Worldwide Emergency for Mothers and Newborns
The numbers are probably a substantial underreporting, as they only include incidents documented publicly. In many conflict zones, reporting is limited.
Last year, it was reported that half of all women who died during pregnancy or childbirth resided in a war zone. This underscores a catastrophic reality.
Apart from fatalities, these attacks are destroying maternal and neonatal care facilities, posing a long-term threat to demographic stability.
Conditions within Gaza
In Gaza, the catastrophic impact on reproductive health rights has been cited by a UN commission as a factor in accusations of genocidal acts.
Following truces, doctors report that women and children are still perishing from medical shortages, owing to critical shortages of medicine and equipment. Accounts describe women giving birth in rubble because hospitals were inaccessible.
“We’ve had rockets targeting the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or trying to alter birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 hospitals for mothers and babies have been damaged or destroyed in Ukraine. Journalism from conflict zones describe births occurring in shelters 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. Officials from Russia have rejected deliberately targeting civilians.
“In fact, every facility is now a potential target,” states a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris may hit a hospital.”
Accountability Evaporates
For the more than 676 million women living near active conflicts, there are minimal protections and a stark lack of legal accountability for those assaulting reproductive health.
This lack of accountability has fostered a “culture of impunity,” explains a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, are potentially acts of genocide by hindering reproduction.”
Other Conflict Zones
In El Fasher, the area lacked access to 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 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 suffered violence over the past two years of civil war.
The End of Safe Deliveries
A large proportion of mother deaths are avoidable with standard medicine, but war collapses medical infrastructure. Rights groups note that fear is now driving women away from facilities once considered safe, resulting in risky home births without skilled assistance.
“The deliberate attack on maternity wards points toward a larger and alarming strategy: the use of violence against hospitals as a means of intimidation 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 ‘prejudicial to the opposing side’, which has now become a standard defence.”
