A group of thirty mothers were seeking shelter in a maternity hospital in El Fasher, Sudan, as the slaughter began. Among them were new mothers, while others were actively in labor.
Working that night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “I heard the screams of women and children,” he recounts. “They were killing everyone inside the hospital. Those who could run, fled.”
This brutal attack stands as one of the most shocking examples in the two-year civil war tearing the North African nation apart. Armed soldiers raided the hospital, reportedly killing 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 living amidst warfare in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence On Childbirth Services
While all major powers are signatories 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 particularly at risk due to their need for locally available medical care.
Research and compiled data reveal an shocking trend: nearly 300 violent acts against places and people associated with childbirth over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These are not inevitable outcomes of conflict. They constitute a systematic assault on childbirth.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where a vast number of women bearing children are confined.
Deaths have occurred, denied medical attention, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 taken hostage, and 101 detained—sometimes while assisting births.
A Worldwide Emergency in Maternal Health
Statistics are thought to be a substantial underreporting, as they are limited to incidents documented publicly. In many conflict zones, communications are sparse.
Last year, it was reported that 50% of women who died during pregnancy or childbirth lived amidst hostilities. This underscores a devastating pattern.
In addition to the loss of life, these attacks are obliterating hospitals and wards, jeopardizing the future to community survival.
Conditions within Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as a factor in declaring certain actions a genocide.
Despite periods of calm, doctors report that women and children are still perishing from inadequate care, owing to desperate lacks of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals were inaccessible.
“Our facility has endured missile strikes hitting the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or seeking to affect birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 childbirth centers have been struck and ruined in Ukraine. Accounts from embattled medical centers describe births forced underground and skyrocketing stress leading to maternal health issues.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“In fact, every facility can be under attack now,” states a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris can strike a hospital.”
Accountability Evaporates
For the hundreds of millions of women living within range of fighting, there are scarce guarantees and rare trials for atrocities for those assaulting reproductive health.
This lack of accountability has led to a “culture of impunity,” explains a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, may constitute acts of genocide by destroying a group's future.”
Additional Hotspots
In El Fasher, the area was isolated from 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 limited by a lack of access from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, killing mothers, babies, and nurses.
In Myanmar, clinics have been attacked and dozens of midwives and patients have faced detention, death, or harm over the past two years of civil war.
The End of Safe Deliveries
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 devoid of emergency care.
“When childbirth centers become intentional targets indicates a larger and alarming strategy: the use of attacks on medical facilities as a weapon to spread fear 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 now become a standard defence.”
