Thirty women were huddled for safety in a childbirth facility in El Fasher, Sudan, when the massacre started. 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, managed to survive the ordeal. “The sounds of screaming reached me of women and children,” he states. “They were killing everyone inside the hospital. Survival meant running for your life.”
This horrifying event stands as among the worst examples in the two-year civil war tearing the North African nation apart. Combatants forced their way into the building, leaving dead more than 460 innocent people inside.
Rights organizations have called it “an unspeakable atrocity,” and a prime example of the vanishing safeguards for civilians living amidst warfare in multiple global hotspots.
A Record of Violence Against Maternal Care
Despite every significant nation are signatories to the Geneva conventions, which obligate them to protect civilians, the past year has experienced a historic high of violence targeting health services. Women undergoing childbirth are exceptionally vulnerable due to their dependence on locally available medical care.
Data analysis and investigations uncover an alarming level of violence: nearly 300 incidents targeting or hindering maternity care facilities, staff, and pregnant women over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“This is not inevitable outcomes of conflict. They constitute a systematic assault on childbirth.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where hundreds of thousands of pregnant women are trapped.
Women have been killed, 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 murdered, 15 abducted, and 101 arrested—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
Statistics are thought to be a significant underestimate, as they are limited to incidents documented publicly. In many areas of fighting, communications are sparse.
Last year, it was reported that one in two mothers who perished while pregnant or giving birth resided in a war zone. This underscores a devastating pattern.
Apart from fatalities, these attacks are wrecking hospitals and wards, creating a grave danger to community survival.
Conditions within Gaza
In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as part of the basis for declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children succumb from a lack of proper treatment, owing to critical shortages of medicine and equipment. Accounts describe women giving birth in rubble because hospitals were out of reach.
“Direct shelling targeting the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or aiming to influence birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 childbirth centers have been attacked and rendered unusable in Ukraine. Reports from frontline hospitals describe births occurring in shelters and extreme psychological pressure leading to birth complications.
“Russia is targeting us deliberately,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The truth of the matter is, every facility is now a potential target,” notes a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris may hit a hospital.”
Accountability Evaporates
For the over half a billion females living close to deadly warfare, there are scarce guarantees and rare trials for atrocities for those attacking childbirth services.
This absence of consequences has led to a “culture of impunity,” argues a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, may constitute acts of genocide by destroying a group's future.”
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 limited by a communication blackout from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, resulting in tragic loss of life.
In Myanmar, hospitals have come under fire and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The Collapse of Safe Childbirth
Most maternal deaths are avoidable with standard medicine, but war shatters health systems. Rights groups note that fear is now driving women away from facilities once considered safe, pushing them toward risky home births lacking professional help.
“When childbirth centers become intentional targets points toward a wider and more disturbing trend: the use of violence against hospitals as a means of intimidation and to tear apart the social fabric,” observes a legal researcher.
“Hospitals are not completely safe 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.”
