A group of thirty mothers had taken refuge in a childbirth facility in El Fasher, Sudan, as the slaughter began. Several had recently given birth, while others were experiencing childbirth.
Working that night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “The sounds of screaming reached me of women and children,” he explains. “They executed everybody inside the hospital. We who were able to escape, did so.”
This brutal attack stands as a particularly egregious examples in the two-year civil war tearing the North African nation apart. Militiamen stormed the facility, allegedly slaughtering more than 460 individuals receiving care and their families.
Rights organizations have called it “a crime beyond words,” and a clear case of the vanishing safeguards for civilians trapped in war-torn areas in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence On Childbirth Services
Although world powers have signed the international laws of war, which commit them to defending civilians, the past year has experienced a historic high of attacks on healthcare systems. Mothers in labor are exceptionally vulnerable due to their reliance on locally available medical care.
An investigation of records uncover an shocking trend: 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.
“These incidents do not represent standard wartime hazards. They form a pattern of reproductive violence.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where a vast number of women bearing children are confined.
Mothers have lost their lives, blocked from reaching help, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been killed, 15 kidnapped, and 101 arrested—sometimes during medical procedures.
The Global Crisis in Maternal Health
Statistics are thought to be a grave undercount, as they capture solely incidents covered by the media. In many war-torn areas, communications are sparse.
Last year, findings indicated that half of all women who died during pregnancy or childbirth lived amidst hostilities. This underscores a horrifying trend.
Apart from fatalities, these attacks are wrecking hospitals and wards, creating a grave danger to community survival.
The Situation in Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as one reason behind declaring certain actions a genocide.
Following truces, doctors report that women and children are still perishing from a lack of proper treatment, owing to severe deficits of medicine and equipment. Accounts describe women giving birth in rubble because hospitals were out of reach.
“We’ve had rockets hitting the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or trying to alter 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 forced underground and extreme psychological pressure leading to maternal health issues.
“Russia is targeting us deliberately,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The reality is, every facility can be under attack now,” comments a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”
Accountability Evaporates
For the over half a billion females living close to deadly warfare, there are few safeguards and a stark lack of legal accountability for those attacking childbirth services.
This lack of accountability has created a “environment where anything goes,” explains a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, may constitute acts of genocide by preventing births.”
Other Conflict Zones
In El Fasher, the area had been cut off 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 scarce because of a communication blackout from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, resulting in tragic loss of life.
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 preventable with routine care, but war collapses medical infrastructure. Rights groups note that terror is compelling women away from facilities once considered safe, resulting in risky home births lacking professional help.
“If maternity hospitals are being deliberately targeted points toward a broader and more sinister pattern: the use of attacks on medical facilities as a means of intimidation and to destroy community bonds,” notes a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘harmful to the enemy’, which has often been cited as an excuse.”
