A group of thirty mothers were seeking shelter in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Several had recently given birth, while others were actively in labor.
On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “The sounds of screaming reached me of women and children,” he states. “They were killing everyone inside the hospital. Those who could run, fled.”
This brutal attack stands as one of the most shocking examples in the protracted internal conflict tearing the African nation apart. Combatants forced their way into the building, leaving dead more than 460 individuals receiving care and their families.
Rights organizations have labeled it “an unspeakable atrocity,” and a prime example of the vanishing safeguards for civilians trapped in war-torn areas in several nations at war.
A Record of Violence On Childbirth Services
Despite every significant nation are signatories to the international laws of war, which require them to safeguard civilians, the past year has experienced a historic high of violence targeting health services. Mothers in labor are exceptionally vulnerable due to their need for locally available medical care.
An investigation of records show an unprecedented scale of attacks: nearly 300 violent acts against places and people associated with childbirth over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These incidents do not represent standard wartime hazards. 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 pregnant women are trapped.
Deaths have occurred, 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 killed, 15 abducted, and 101 arrested—sometimes while assisting births.
The Global Crisis in Maternal Health
Statistics are thought to be a significant underestimate, as they only include incidents covered by the media. In many war-torn areas, reporting is limited.
Last year, analysis showed that 50% of women who perished while pregnant or giving birth were in a conflict area. This underscores a horrifying trend.
In addition to the loss of life, these attacks are wrecking critical infrastructure for mothers and babies, posing a long-term threat to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as one reason behind declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children succumb from medical shortages, owing to critical shortages of medicine and equipment. Accounts describe women giving birth in rubble because hospitals could not be reached.
“We’ve had rockets targeting the wards, operating rooms, and maternity wards,” explains 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 maternity and neonatal facilities have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births taking place in basements and extreme psychological pressure leading to maternal health issues.
“The attacks on us are intentional,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The reality is, every facility can be under attack now,” notes a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris could impact a hospital.”
Accountability Evaporates
For the more than 676 million women living near active conflicts, there are few safeguards and rare trials for atrocities for those targeting maternity care.
This void of justice has created a “environment where anything goes,” argues a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, may constitute acts of genocide by hindering reproduction.”
Additional Hotspots
In El Fasher, the area was isolated 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 limited by a inability to report from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, killing mothers, babies, and nurses.
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 End of Safe Deliveries
A large proportion of mother 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, leading them to risky home births without skilled assistance.
“The deliberate attack on maternity wards points toward a broader and more sinister pattern: the use of attacks on medical facilities as a weapon to spread fear and to destroy community bonds,” notes 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 ‘militarily advantageous’, which has now become a standard defence.”
