Dozens of women were huddled for safety in a childbirth facility in El Fasher, Sudan, as the slaughter began. Some had just delivered their newborns, while others were in the midst of labor.
Working that night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “I heard the screams of women and children,” he recounts. “A massacre was taking place inside the hospital. Survival meant running for your life.”
This horrifying event stands as among the worst examples in the ongoing war tearing the North African nation apart. Militiamen raided the hospital, allegedly slaughtering more than 460 innocent people inside.
Rights organizations have called it “a crime beyond words,” and a prime example of the deteriorating protection for civilians trapped in war-torn areas in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault On Childbirth Services
Despite every significant nation are signatories to the international laws of war, which obligate them to protect civilians, the past year has experienced a historic high of attacks on healthcare systems. Mothers in labor are highly exposed due to their dependence on locally available medical care.
Research and compiled data reveal an unprecedented scale of attacks: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“These incidents do not represent standard wartime hazards. They constitute a systematic assault on childbirth.”
The majority of these incidents have happened in regions embroiled in intense conflict, where countless of women bearing children are confined.
Women have been killed, prevented from accessing care, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been slain, 15 taken hostage, and 101 detained—sometimes while assisting births.
A Worldwide Emergency for Mothers and Newborns
These figures likely represent a grave undercount, as they only include incidents documented publicly. In many areas of fighting, communications are sparse.
Last year, it was reported that one in two mothers who lost their lives in maternal circumstances resided in a war zone. This underscores a devastating pattern.
In addition to the loss of life, these attacks are destroying critical infrastructure for mothers and babies, posing a long-term threat to community survival.
The Situation in Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as part of the basis for genocide allegations.
Even after ceasefires, doctors report that women and children are still perishing from a lack of proper treatment, owing to critical shortages of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals were out of reach.
“Direct shelling targeting 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 aiming to influence birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 childbirth centers have been struck and ruined in Ukraine. Journalism from conflict zones describe births taking place in basements and extreme psychological pressure leading to maternal health issues.
“Russia is targeting us deliberately,” says 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 can be under attack now,” notes a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris could impact a hospital.”
Accountability Evaporates
For the over half a billion females living within range of fighting, there are few safeguards and rare trials for atrocities for those attacking childbirth services.
This lack of accountability has fostered a “atmosphere of lawlessness,” explains a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, are potentially 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 communication blackout from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, causing fatalities among patients and staff.
In Myanmar, hospitals have come under fire and dozens of midwives and patients have suffered violence over the past two years of civil war.
The End of Safe Deliveries
The majority of childbirth fatalities are averted with basic healthcare, but war collapses medical infrastructure. Rights groups note that fear is now driving 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 larger and alarming strategy: the use of attacks on medical facilities as a weapon to spread fear and to tear apart the social fabric,” observes a legal researcher.
“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”
