Thirty women were seeking shelter in a maternity hospital in El Fasher, Sudan, as the slaughter began. Among them were new mothers, while others were experiencing childbirth.
On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “The sounds of screaming reached me of women and children,” he recounts. “A massacre was taking place inside the hospital. Those who could run, fled.”
This appalling incident stands as a particularly egregious examples in the ongoing war tearing the African nation apart. Armed soldiers stormed the facility, leaving dead more than 460 individuals receiving care and their families.
Rights organizations have labeled it “a crime beyond words,” and a stark illustration of the collapse in safety for civilians living amidst warfare in multiple global hotspots.
A Record of Violence Against Maternal Care
Although world powers have agreed to the Geneva conventions, which require them to safeguard civilians, the past year has seen a record number of violence targeting health services. Mothers in labor are highly exposed due to their need for locally available medical care.
An investigation of records uncover an shocking trend: nearly 300 attacks on and disruptions to places and people associated with childbirth over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“These are not inevitable outcomes of conflict. They represent a pattern of reproductive violence.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where hundreds of thousands of pregnant women are trapped.
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 maternal health workers have been slain, 15 taken hostage, and 101 taken into custody—sometimes during medical procedures.
The Global Crisis in Maternal Health
Statistics are thought to be a substantial underreporting, as they only include incidents reported in news outlets. In many conflict zones, information is scarce.
Last year, findings indicated that 50% of women who perished while pregnant or giving birth were in a conflict area. This underscores a horrifying trend.
In addition to the loss of life, these attacks are wrecking critical infrastructure for mothers and babies, 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 part of the basis for declaring certain actions a genocide.
Despite periods of calm, doctors report that women and children continue to die from medical shortages, owing to desperate lacks of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals could not be reached.
“Direct shelling targeting the wards, operating rooms, and maternity wards,” explains 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 maternity and neonatal facilities have been struck and ruined in Ukraine. Journalism from conflict zones describe births occurring in shelters and extreme psychological pressure leading to maternal health issues.
“Russia is targeting us deliberately,” asserts 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. “If a drone is destroyed, the falling debris can strike a hospital.”
A Culture of Impunity
For the over half a billion females living near active conflicts, there are scarce guarantees and rare trials for atrocities for those assaulting reproductive health.
This absence of consequences has led to a “environment where anything goes,” says a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, 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 scarce because of a lack of access from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, killing mothers, babies, and nurses.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The Collapse of Safe Childbirth
Most maternal deaths are preventable with routine care, but war destroys healthcare networks. Rights groups note that anxiety is forcing women away from facilities once considered safe, pushing them toward risky home births without skilled assistance.
“The deliberate attack on maternity wards indicates a broader and more sinister pattern: the use of violence against hospitals as a tool for terror and to break societal cohesion,” observes a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”
