A group of thirty mothers were seeking shelter in a childbirth facility in El Fasher, Sudan, when the massacre started. Several had recently given birth, while others were in the midst of labor.
Present at the hospital after dark, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “There were cries of women and children,” he states. “They were killing everyone inside the hospital. Those who could run, fled.”
This brutal attack stands as among the worst examples in the protracted internal conflict tearing the African nation apart. Armed soldiers forced their way into the building, leaving dead more than 460 innocent people inside.
Rights organizations have called it “an unspeakable atrocity,” and a prime example of the collapse in safety for civilians living amidst warfare in several nations at war.
A Record of Violence Against Maternal Care
Although world powers have agreed to the international laws of war, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of assaults against medical infrastructure. Expectant mothers are highly exposed due to their need for locally available medical care.
Data analysis and investigations show an unprecedented scale of attacks: nearly 300 incidents targeting or hindering places and people associated with childbirth over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“This is not natural consequences of war. They represent a pattern of reproductive violence.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where hundreds of thousands of pregnant women are trapped.
Mothers have lost their lives, blocked from reaching help, or made to have their babies in dangerous and unsanitary conditions. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 taken hostage, and 101 taken into custody—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
The numbers are probably a significant underestimate, as they are limited to incidents reported in news outlets. In many war-torn areas, reporting is limited.
Last year, analysis showed that half of all women who perished while pregnant or giving birth resided in a war zone. This underscores a devastating pattern.
Apart from fatalities, these attacks are wrecking hospitals and wards, jeopardizing the future to community survival.
Conditions within Gaza
In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as part of the basis for accusations of genocidal acts.
Despite periods of calm, doctors report that women and children are still perishing from a lack of proper treatment, owing to desperate lacks of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals were out of reach.
“We’ve had rockets targeting the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or trying to alter birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 hospitals for mothers and babies have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births taking place in basements and extreme psychological pressure leading to problems during delivery.
“Russia is targeting us deliberately,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“In fact, every facility faces the threat of assault,” notes a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris may hit a hospital.”
Accountability Evaporates
For the over half a billion females living near active conflicts, there are minimal protections and even fewer war crimes prosecutions for those assaulting reproductive health.
This absence of consequences has led to a “environment where anything goes,” explains 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 rising sharply, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is restricted due to a communication blackout from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, killing mothers, babies, and nurses.
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 Collapse of Safe Childbirth
Most maternal deaths are averted with basic healthcare, but war shatters health systems. Rights groups note that fear is now driving women away from facilities once considered safe, leading them to risky home births without skilled assistance.
“When childbirth centers become intentional targets indicates a broader and more sinister pattern: the use of attacks on medical facilities as a means of intimidation and to destroy community bonds,” 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 ‘militarily advantageous’, which has now become a standard defence.”
