Thirty women were seeking shelter in a maternity hospital in El Fasher, Sudan, as the slaughter began. Among them were new mothers, while others were in the midst of labor.
Working that 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 explains. “A massacre was taking place inside the hospital. Those who could run, fled.”
This brutal attack stands as among the worst examples in the two-year civil war tearing the African nation apart. Militiamen raided the hospital, reportedly killing more than 460 innocent people inside.
Rights organizations have labeled it “an act of unspeakable brutality,” and a prime example of the deteriorating protection for civilians living amidst warfare in several nations at war.
An Unprecedented Assault Against Maternal Care
Although world powers have signed the Geneva conventions, which obligate them to protect 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.
An investigation of records show an unprecedented scale of attacks: nearly 300 incidents targeting or hindering places and people associated with childbirth over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“These are not inevitable outcomes of conflict. They represent a systematic assault on childbirth.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where a vast number of expectant mothers are stranded.
Deaths have occurred, prevented from accessing care, or compelled to deliver in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 abducted, and 101 taken into custody—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
The numbers are probably a substantial underreporting, as they are limited to incidents reported in news outlets. In many conflict zones, information is scarce.
Last year, findings indicated that one in two mothers who lost their lives in maternal circumstances resided in a war zone. This underscores a devastating pattern.
Beyond killing women and staff, these attacks are obliterating hospitals and wards, creating a grave danger to demographic stability.
Conditions within Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as part of the basis for genocide allegations.
Following truces, doctors report that women and children succumb from inadequate care, owing to desperate lacks of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals were inaccessible.
“Direct shelling fired at 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.
Ukraine's Ordeal
Since early 2022, at least 80 childbirth centers have been damaged or destroyed in Ukraine. Journalism from conflict zones describe births taking place in basements and skyrocketing stress leading to problems during delivery.
“The attacks on us are intentional,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The reality is, every facility can be under attack now,” states a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris can strike a hospital.”
Accountability Evaporates
For the more than 676 million women living near active conflicts, there are scarce guarantees and even fewer war crimes prosecutions for those targeting maternity care.
This void of justice has led to a “atmosphere of lawlessness,” says a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, may constitute acts of genocide by preventing births.”
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, killing mothers, babies, and nurses.
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
The majority of childbirth fatalities are averted with basic healthcare, but war shatters health systems. Rights groups note that anxiety is forcing women away from facilities once considered safe, pushing them toward risky home births without skilled assistance.
“If maternity hospitals are being deliberately targeted speaks to a larger and alarming strategy: the use of attacks on medical facilities as a weapon to spread fear and to break societal cohesion,” observes a legal researcher.
“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘harmful to the enemy’, which has often been cited as an excuse.”
