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, a technician named Abdo-Rabo Ahmed, became one of the few known survivors. “I heard the screams of women and children,” he explains. “A massacre was taking place inside the hospital. Survival meant running for your life.”
This appalling incident stands as one of the most shocking examples in the two-year civil war tearing the North African nation apart. Combatants forced their way into the building, allegedly slaughtering more than 460 patients and their companions.
Rights organizations have described it as “an act of unspeakable brutality,” and a prime example of the collapse in safety for civilians caught in conflict zones in several nations at war.
An Unprecedented Assault Against Maternal Care
Although world powers have signed the Geneva conventions, which obligate them to protect civilians, the past year has seen a record number of assaults against medical infrastructure. Expectant mothers are particularly at risk due to their dependence on locally available medical care.
Research and compiled data show an alarming level of violence: nearly 300 attacks on and disruptions to maternity care facilities, staff, and pregnant women over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“These are not inevitable outcomes of conflict. They form a systematic assault on childbirth.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where a vast number of women bearing children are confined.
Mothers have lost their lives, prevented from accessing care, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 kidnapped, and 101 detained—sometimes while assisting births.
A Worldwide Emergency in Maternal Health
Statistics are thought to be a grave undercount, as they only include incidents reported in news outlets. In many conflict zones, information is scarce.
Last year, it was reported that one in two mothers who lost their lives in maternal circumstances lived amidst hostilities. This underscores a devastating pattern.
Apart from fatalities, these attacks are destroying maternal and neonatal care facilities, creating a grave danger to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as one reason behind genocide allegations.
Following truces, doctors report that women and children are still perishing from a lack of proper treatment, owing to desperate lacks of medicine and equipment. Agencies have reported women having children by the roadside because hospitals were inaccessible.
“We’ve had rockets fired at 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 trying to alter birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 childbirth centers have been struck and ruined in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and skyrocketing stress leading to birth complications.
“The attacks on us are intentional,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“The reality is, every facility is now a potential target,” notes a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris could impact a hospital.”
A Culture of Impunity
For the over half a billion females living close to deadly warfare, there are minimal protections and a stark lack of legal accountability for those targeting maternity care.
This absence of consequences has created a “environment where anything goes,” says a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, may constitute acts of genocide by destroying a group's future.”
Other Conflict Zones
In El Fasher, the area had been cut off from 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 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 suffered violence over the past two years of civil war.
The Collapse of Safe Childbirth
A large proportion of mother deaths are avoidable with standard medicine, but war shatters health systems. Rights groups note that terror is compelling women away from facilities once considered safe, pushing them toward risky home births without skilled assistance.
“The deliberate attack on maternity wards points toward a larger and alarming strategy: the use of violence against hospitals as a means of intimidation and to destroy community bonds,” notes a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘prejudicial to the opposing side’, which has increasingly been used as a justification.”
