A group of thirty mothers were seeking shelter in a childbirth facility in El Fasher, Sudan, as the slaughter began. Some had just delivered their newborns, while others were experiencing childbirth.
On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, became one of the few known survivors. “I heard the screams of women and children,” he recounts. “They executed everybody inside the hospital. Survival meant running for your life.”
This horrifying event stands as among the worst examples in the ongoing war tearing the African nation apart. Armed soldiers stormed the facility, leaving dead more than 460 patients and their companions.
Rights organizations have labeled it “an unspeakable atrocity,” and a clear case of the vanishing safeguards for civilians living amidst warfare in several nations at war.
An Unprecedented Assault On Childbirth Services
Despite every significant nation are signatories to the Geneva conventions, which commit them to defending civilians, the past year has experienced a historic high of violence targeting health services. Mothers in labor are highly exposed due to their need for locally available medical care.
Research and compiled data uncover 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 targeted attacks against hospitals and delivery wards.
“This is not standard wartime hazards. They constitute a deliberate strategy of violence against reproduction.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where countless of women bearing children are confined.
Mothers have lost their lives, denied medical attention, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been slain, 15 kidnapped, and 101 taken into custody—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
These figures likely represent a significant underestimate, as they are limited to incidents reported in news outlets. In many war-torn areas, communications are sparse.
Last year, findings indicated that one in two mothers who died during pregnancy or childbirth resided in a war zone. This underscores a devastating pattern.
Beyond killing women and staff, these attacks are wrecking hospitals and wards, creating a grave danger to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the ruinous consequences on reproductive health rights has been cited by a UN commission as a factor in accusations of genocidal acts.
Even after ceasefires, doctors report that women and children continue to die from a lack of proper treatment, owing to critical shortages of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals were out of reach.
“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 denied deliberately targeting maternity care or aiming to influence birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been attacked and rendered unusable in Ukraine. Reports from frontline hospitals describe births forced underground and extreme psychological pressure leading to maternal health issues.
“We are being singled out,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“The truth of the matter is, every facility can be under attack now,” comments a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
Accountability Evaporates
For the hundreds of millions of women living close to deadly warfare, there are minimal protections and a stark lack of legal accountability for those assaulting reproductive health.
This absence of consequences has fostered a “environment where anything goes,” explains a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, are potentially acts of genocide by hindering reproduction.”
Other Conflict Zones
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 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 suffered violence over the past two years of civil war.
The Collapse of Safe Childbirth
Most maternal 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, resulting in risky home births lacking professional help.
“When childbirth centers become intentional targets 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 are not inviolable if used for acts deemed ‘militarily advantageous’, which has often been cited as an excuse.”
