A group of thirty mothers had taken refuge in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Some had just delivered their newborns, while others were in the midst of labor.
On duty during that fateful 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 explains. “They executed everybody inside the hospital. We who were able to escape, did so.”
This brutal attack stands as one of the most shocking examples in the ongoing war tearing the African nation apart. Armed soldiers stormed the facility, leaving dead more than 460 innocent people inside.
Rights organizations have called it “an act of unspeakable brutality,” and a stark illustration of the deteriorating protection for civilians living amidst warfare in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault Against Maternal Care
Although world powers are signatories to the international laws of war, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of assaults against medical infrastructure. Expectant mothers are exceptionally vulnerable due to their need for locally available medical care.
Data analysis and investigations reveal an alarming level of violence: nearly 300 attacks on and disruptions to maternity care facilities, staff, and pregnant women 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 pattern of reproductive violence.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where countless of expectant mothers are stranded.
Women have been killed, prevented from accessing care, or made to have their babies in deplorable situations. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 taken hostage, and 101 arrested—sometimes in the act of delivering babies.
The Global Crisis in Maternal Health
The numbers are probably a substantial underreporting, as they only include incidents documented publicly. In many areas of fighting, information is scarce.
Last year, findings indicated that half of all 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 obliterating hospitals and wards, jeopardizing the future to community survival.
Conditions within Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as a factor in accusations of genocidal acts.
Despite periods of calm, doctors report that women and children continue to die from a lack of proper treatment, owing to severe deficits of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals could not be reached.
“We’ve had rockets fired at 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 seeking to affect birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 hospitals for mothers and babies have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and extreme psychological pressure leading to maternal health issues.
“Russia is targeting us deliberately,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“In fact, 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 few safeguards and a stark lack of legal accountability for those targeting maternity care.
This lack of accountability has created a “atmosphere of lawlessness,” argues a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, are potentially acts of genocide by destroying a group's future.”
Other Conflict Zones
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 restricted due to a communication blackout from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, resulting in tragic loss of life.
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
The majority of childbirth fatalities are preventable with routine care, but war collapses medical infrastructure. Rights groups note that fear is now driving women away from facilities once considered safe, resulting in risky home births without skilled assistance.
“When childbirth centers become intentional targets points toward a broader and more sinister pattern: 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 can lose their protected status if used for acts deemed ‘militarily advantageous’, which has often been cited as an excuse.”
