Dozens of women were huddled for safety in a childbirth facility in El Fasher, Sudan, as the slaughter began. 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 recounts. “They executed everybody inside the hospital. Those who could run, fled.”
This appalling incident stands as a particularly egregious examples in the ongoing war tearing the North African nation apart. Militiamen forced their way into the building, allegedly slaughtering more than 460 patients and their companions.
Rights organizations have described it as “an unspeakable atrocity,” and a prime example of the collapse in safety for civilians living amidst warfare in multiple global hotspots.
An Unprecedented Assault Against Maternal Care
Although world powers are signatories to the international laws of war, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Women undergoing childbirth are highly exposed due to their reliance on locally available medical care.
An investigation of records show an unprecedented scale of attacks: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“These are not 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 women bearing children are confined.
Deaths have occurred, denied medical attention, or made to have their babies in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 abducted, and 101 detained—sometimes in the act of delivering babies.
A Worldwide Emergency for Mothers and Newborns
These figures likely represent a significant underestimate, as they capture solely incidents documented publicly. In many conflict zones, communications are sparse.
Last year, analysis showed that one in two mothers who perished while pregnant or giving birth were in a conflict area. This underscores a devastating pattern.
Apart from fatalities, these attacks are wrecking critical infrastructure for mothers and babies, jeopardizing the future to community survival.
The Situation in Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as a factor in declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children succumb from a lack of proper treatment, owing to severe deficits of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals could not be reached.
“We’ve had rockets fired at the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or aiming to influence birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 hospitals for mothers and babies have been attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births taking place in basements and skyrocketing stress leading to maternal health issues.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“In fact, every facility can be under attack now,” comments a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris can strike a hospital.”
Accountability Evaporates
For the over half a billion females living close to deadly warfare, there are few safeguards and a stark lack of legal accountability for those attacking childbirth services.
This void of justice has led to a “environment where anything goes,” says a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, can be understood as acts of genocide by hindering reproduction.”
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 restricted due to a communication blackout from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, 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 avoidable with standard medicine, but war destroys healthcare networks. Rights groups note that anxiety is forcing women away from facilities once considered safe, leading them to risky home births without skilled assistance.
“The deliberate attack on maternity wards indicates a broader and more sinister pattern: the use of attacks on medical facilities as a weapon to spread fear and to destroy community bonds,” says a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has often been cited as an excuse.”
