A group of thirty mothers were seeking shelter in a childbirth facility in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, while others were actively in labor.
Working that night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “I heard the screams of women and children,” he recounts. “They were killing everyone inside the hospital. Those who could run, fled.”
This appalling incident stands as one of the most shocking examples in the ongoing war tearing the North African nation apart. Armed soldiers raided the hospital, allegedly slaughtering more than 460 patients and their companions.
Rights organizations have labeled it “a crime beyond words,” and a clear case of the vanishing safeguards for civilians caught in conflict zones in several nations at war.
An Unprecedented Assault Against Maternal Care
While all major powers have signed the international laws of war, which obligate them to protect civilians, the past year has experienced a historic high of violence targeting health services. Women undergoing childbirth are particularly at risk due to their dependence on locally available medical care.
Research and compiled data uncover an unprecedented scale of attacks: nearly 300 violent acts against 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 standard wartime hazards. They constitute 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.
Deaths have occurred, prevented from accessing care, or made to have their babies in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 abducted, and 101 taken into custody—sometimes in the act of delivering babies.
A Worldwide Emergency in Maternal Health
The numbers are probably a significant underestimate, as they only include incidents documented publicly. In many conflict zones, communications are sparse.
Last year, findings indicated that one in two mothers who died during pregnancy or childbirth resided in a war zone. This underscores a devastating pattern.
In addition to the loss of life, these attacks are destroying hospitals and wards, posing a long-term threat 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 one reason behind accusations of genocidal acts.
Even after ceasefires, doctors report that women and children are still perishing from a lack of proper treatment, owing to critical shortages of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals were out of reach.
“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 damaged or destroyed in Ukraine. Accounts from embattled medical centers describe births forced underground and skyrocketing stress leading to birth complications.
“The attacks on us are intentional,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“In fact, every facility is now a potential target,” states a medical director in Sumy. “Even if air defence intercepts a drone, 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 a stark lack of legal accountability for those assaulting reproductive health.
This lack of accountability has created a “culture of impunity,” says a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, are potentially 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 scarce because of a lack of access from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, killing mothers, babies, and nurses.
In Myanmar, medical facilities have been bombed 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 anxiety is forcing women away from facilities once considered safe, pushing them toward risky home births without skilled assistance.
“When childbirth centers become intentional targets points toward a wider and more disturbing trend: the use of violence against hospitals as a weapon to spread fear and to destroy community bonds,” observes a legal researcher.
“Safeguards are not guaranteed 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.”
