A group of thirty mothers were huddled for safety in a maternity hospital in El Fasher, Sudan, when the massacre started. Among them were new mothers, 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. “There were cries 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 among the worst examples in the protracted internal conflict tearing the North African nation apart. Combatants raided the hospital, leaving dead more than 460 patients and their companions.
Rights organizations have labeled it “a crime beyond words,” and a clear case of the deteriorating protection for civilians caught in conflict zones in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence Against Maternal Care
While all major powers have signed the Geneva conventions, which require them to safeguard civilians, the past year has experienced a historic high of violence targeting health services. Mothers in labor are particularly at risk due to their dependence on locally available medical care.
Data analysis and investigations reveal an alarming level of violence: nearly 300 attacks on and disruptions to places and people associated with childbirth over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“These incidents do not represent standard wartime hazards. They constitute a systematic assault on childbirth.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where hundreds of thousands of pregnant women are trapped.
Women have been killed, prevented from accessing care, or forced to give birth in dangerous and unsanitary conditions. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 abducted, and 101 taken into custody—sometimes in the act of delivering babies.
The Global Crisis for Mothers and Newborns
These figures likely represent a grave undercount, as they capture solely incidents reported in news outlets. In many war-torn areas, communications are sparse.
Last year, it was reported that one in two mothers who died during pregnancy or childbirth lived amidst hostilities. This underscores a horrifying trend.
Apart from fatalities, these attacks are wrecking hospitals and wards, jeopardizing the future 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.
Even after ceasefires, doctors report that women and children are still perishing from inadequate care, owing to critical shortages of medicine and equipment. Agencies have reported women having children by the roadside because hospitals were inaccessible.
“Our facility has endured missile strikes fired at the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or aiming to influence birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 hospitals for mothers and babies have been struck and ruined in Ukraine. Journalism from conflict zones describe births occurring in shelters and skyrocketing stress leading to maternal health issues.
“Russia is targeting us deliberately,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“In fact, every facility is now a potential target,” states 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 close to deadly warfare, there are scarce guarantees and rare trials for atrocities for those attacking childbirth services.
This absence of consequences 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 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, clinics have been attacked 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
A large proportion of mother deaths are preventable with routine care, but war shatters health systems. Rights groups note that anxiety is forcing women away from facilities once considered safe, leading them to 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 tool for terror and to tear apart the social fabric,” notes a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has increasingly been used as a justification.”
