A group of thirty mothers had taken refuge in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. 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, managed to survive the ordeal. “I heard the screams of women and children,” he explains. “They executed everybody inside the hospital. Those who could run, fled.”
This brutal attack stands as among the worst examples in the protracted internal conflict tearing the African nation apart. Militiamen forced their way into the building, allegedly slaughtering more than 460 individuals receiving care and their families.
Rights organizations have called it “a crime beyond words,” and a clear case of the deteriorating protection for civilians caught in conflict zones in multiple global hotspots.
An Unprecedented Assault On Childbirth Services
While all major powers have agreed to the international laws of war, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Expectant mothers are particularly at risk due to their dependence on locally available medical care.
Research and compiled data 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 incidents do not represent inevitable outcomes of conflict. They form a pattern of reproductive violence.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where hundreds of thousands of women bearing children are confined.
Women have been killed, denied medical attention, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 abducted, and 101 arrested—sometimes while assisting births.
The Global Crisis in Maternal Health
These figures likely represent a significant underestimate, as they capture solely incidents documented publicly. In many conflict zones, reporting is limited.
Last year, analysis showed that half of all women who perished while pregnant or giving birth lived amidst hostilities. This underscores a devastating pattern.
In addition to the loss of life, these attacks are destroying hospitals and wards, creating a grave danger to community survival.
The Situation in Gaza
In Gaza, the ruinous consequences on reproductive health rights has been cited by a UN commission as a factor in genocide allegations.
Following truces, doctors report that women and children are still perishing from medical shortages, owing to desperate lacks of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals were inaccessible.
“Direct shelling targeting the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or seeking to affect 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 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.
“The reality is, every facility faces the threat of assault,” comments a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris can strike a hospital.”
A Culture of Impunity
For the more than 676 million women living within range of fighting, there are minimal protections and even fewer war crimes prosecutions for those assaulting reproductive health.
This void of justice has led to a “environment where anything goes,” argues a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, are potentially acts of genocide by preventing births.”
Other Conflict Zones
In El Fasher, the area had been cut off from humanitarian aid long before the hospital attack, with malnutrition spiking dangerously, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is restricted due to a inability to report from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, causing fatalities among patients and staff.
In Myanmar, hospitals have come under fire 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
A large proportion of mother deaths are avoidable with standard medicine, but war destroys healthcare networks. Rights groups note that terror is compelling women away from facilities once considered safe, leading them to risky home births without skilled assistance.
“The deliberate attack on maternity wards indicates a larger and alarming strategy: the use of violence against hospitals as a means of intimidation and to break societal cohesion,” says a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has increasingly been used as a justification.”
