Thirty women were huddled for safety in a maternity hospital 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, Abdo-Rabo Ahmed, managed to survive the ordeal. “The sounds of screaming reached me of women and children,” he recounts. “They were killing everyone inside the hospital. Those who could run, fled.”
This horrifying event stands as one of the most shocking examples in the protracted internal conflict tearing the North African nation apart. Armed soldiers stormed the facility, reportedly killing more than 460 individuals receiving care and their families.
Rights organizations have labeled it “an unspeakable atrocity,” and a clear case of the vanishing safeguards for civilians trapped in war-torn areas in several nations at war.
A Record of Violence On Childbirth Services
Although world powers have signed the Geneva conventions, which commit them to defending civilians, the past year has witnessed an unprecedented spike of assaults against medical infrastructure. Mothers in labor are particularly at risk due to their need for locally available medical care.
Data analysis and investigations show 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.
“This is not natural consequences of war. They represent a deliberate strategy of violence against reproduction.”
The majority of these assaults have occurred 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 made to have their babies in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been slain, 15 abducted, and 101 arrested—sometimes while assisting births.
The Global Crisis for Mothers and Newborns
These figures likely represent a substantial underreporting, as they only include incidents documented publicly. In many areas of fighting, communications are sparse.
Last year, it was reported that one in two mothers who lost their lives in maternal circumstances were in a conflict area. This underscores a devastating pattern.
Apart from fatalities, these attacks are wrecking critical infrastructure for mothers and babies, creating a grave danger to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the catastrophic impact on reproductive health rights has been cited by a UN commission as part of the basis for accusations of genocidal acts.
Even after ceasefires, doctors report that women and children continue to die from medical shortages, owing to severe deficits of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals were out of reach.
“Direct shelling fired at the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or trying to alter birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been damaged or destroyed in Ukraine. Reports from frontline hospitals describe births occurring in shelters and extreme psychological pressure leading to problems during delivery.
“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 is now a potential target,” comments a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris may hit a hospital.”
A Culture of Impunity
For the over half a billion females living close to deadly warfare, there are few safeguards and even fewer war crimes prosecutions for those assaulting reproductive health.
This lack of accountability has created a “environment where anything goes,” says a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, may constitute acts of genocide by hindering reproduction.”
Additional Hotspots
In El Fasher, the area lacked access to 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 inability to report from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, resulting in tragic loss of life.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have faced detention, death, or harm over the past two years of civil war.
The Collapse of Safe Childbirth
The majority of childbirth fatalities are preventable with routine care, but war collapses medical infrastructure. Rights groups note that anxiety is forcing women away from facilities once considered safe, resulting in risky home births without skilled assistance.
“If maternity hospitals are being deliberately targeted 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.
“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.”
