Thirty women were huddled for safety in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. Several had recently given birth, while others were actively in labor.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “There were cries of women and children,” he states. “They executed everybody inside the hospital. Those who could run, fled.”
This appalling incident stands as a particularly egregious examples in the ongoing war tearing the North African nation apart. Combatants forced their way into the building, reportedly killing more than 460 innocent people inside.
Rights organizations have labeled it “an unspeakable atrocity,” and a prime example of the vanishing safeguards for civilians living amidst warfare in several nations at war.
An Unprecedented Assault On Childbirth Services
Despite every significant nation have agreed to the international laws of war, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of attacks on healthcare systems. Mothers in labor are exceptionally vulnerable due to their reliance on locally available medical care.
Research and compiled data uncover an shocking trend: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“These are not standard wartime hazards. They represent a systematic assault on childbirth.”
The majority of these incidents have happened in regions embroiled in intense conflict, where hundreds of thousands of expectant mothers are stranded.
Mothers have lost their lives, blocked from reaching help, or compelled to deliver in dangerous and unsanitary conditions. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 abducted, and 101 arrested—sometimes during medical procedures.
The Global Crisis in Maternal Health
The numbers are probably a grave undercount, as they only include incidents covered by the media. In many war-torn areas, communications are sparse.
Last year, analysis showed that one in two mothers who lost their lives in maternal circumstances were in a conflict area. This underscores a horrifying trend.
Beyond killing women and staff, these attacks are obliterating hospitals and wards, posing a long-term threat to demographic stability.
The Situation in 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 continue to die from medical shortages, owing to severe deficits of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals were inaccessible.
“Our facility has endured missile strikes targeting the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or seeking to affect birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 childbirth centers have been damaged or destroyed in Ukraine. Reports from frontline hospitals describe births forced underground and extreme psychological pressure leading to problems during delivery.
“We are being singled out,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied 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.”
A Culture of Impunity
For the more than 676 million women living close to deadly warfare, there are few safeguards and rare trials for atrocities for those targeting maternity care.
This void of justice has created a “culture of impunity,” says a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, are potentially acts of genocide by preventing births.”
Other Conflict Zones
In El Fasher, the area lacked access to 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 limited by 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, hospitals have come under fire and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The End of Safe Deliveries
Most maternal deaths are avoidable with standard medicine, but war destroys healthcare networks. Rights groups note that anxiety is forcing women away from facilities once considered safe, leading them to risky home births lacking professional help.
“When childbirth centers become intentional targets speaks to a broader and more sinister pattern: the use of attacks on medical facilities as a tool for terror and to destroy community bonds,” notes a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘prejudicial to the opposing side’, which has increasingly been used as a justification.”
