Thirty women had taken refuge in a maternity hospital in El Fasher, Sudan, as the slaughter began. Some had just delivered their newborns, while others were experiencing childbirth.
Working that night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, became one of the few known survivors. “The sounds of screaming reached me of women and children,” he states. “They executed everybody inside the hospital. Survival meant running for your life.”
This appalling incident stands as a particularly egregious examples in the two-year civil war tearing the African nation apart. Militiamen stormed the facility, leaving dead more than 460 innocent people inside.
Rights organizations have described it as “a crime beyond words,” and a clear case of the deteriorating protection for civilians trapped in war-torn areas in multiple global hotspots.
A Record of Violence On Childbirth Services
Although world powers are signatories to the Geneva conventions, which commit them to defending civilians, the past year has seen a record number of violence targeting health services. Women undergoing childbirth are particularly at risk due to their reliance on locally available medical care.
Data analysis and investigations uncover an alarming level of violence: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“This is not inevitable outcomes of conflict. They represent 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.
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 childbirth professionals and specialists have been slain, 15 kidnapped, and 101 arrested—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
Statistics are thought to be a grave undercount, as they are limited to incidents covered by the media. In many conflict zones, 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 catastrophic reality.
Beyond killing women and staff, these attacks are obliterating critical infrastructure for mothers and babies, posing a long-term threat to community survival.
Conditions within Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as part of the basis for accusations of genocidal acts.
Following truces, doctors report that women and children are still perishing from a lack of proper treatment, owing to critical shortages of medicine and equipment. UN officials have relayed women having children by the roadside because hospitals were inaccessible.
“Direct shelling hitting the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or seeking to affect birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 childbirth centers have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers 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. Russian authorities have denied deliberately targeting civilians.
“The reality is, every facility faces the threat of assault,” comments a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
A Culture of Impunity
For the more than 676 million women living near active conflicts, there are few safeguards and a stark lack of legal accountability for those assaulting reproductive health.
This absence of consequences has fostered a “culture of impunity,” explains a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, can be understood as acts of genocide by destroying a group's future.”
Additional Hotspots
In El Fasher, the area had been cut off 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 limited by a communication blackout from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, causing fatalities among patients and staff.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The End of Safe Deliveries
Most maternal deaths are avoidable with standard medicine, but war collapses medical infrastructure. Rights groups note that terror is compelling women away from facilities once considered safe, leading them to risky home births devoid of emergency care.
“The deliberate attack on maternity wards indicates 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 ‘militarily advantageous’, which has increasingly been used as a justification.”
