Thirty women were seeking shelter in a childbirth facility in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, while others were in the midst of labor.
Working that night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “The sounds of screaming reached me of women and children,” he explains. “They executed everybody inside the hospital. Those who could run, fled.”
This appalling incident stands as one of the most shocking examples in the ongoing war tearing the North African nation apart. Militiamen stormed the facility, allegedly slaughtering more than 460 innocent people inside.
Rights organizations have called it “an unspeakable atrocity,” and a stark illustration of the deteriorating protection for civilians living amidst warfare in several nations at war.
An Unprecedented Assault Against Maternal Care
Although world powers are signatories to the international laws of war, which obligate them to protect civilians, the past year has experienced a historic high of attacks on healthcare systems. Expectant mothers are particularly at risk due to their reliance on locally available medical care.
Research and compiled data show an alarming level of violence: 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.
“This is not inevitable outcomes of conflict. They constitute a deliberate strategy of violence against reproduction.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where countless of pregnant women are trapped.
Women have been killed, blocked from reaching help, or forced to give birth in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 kidnapped, and 101 detained—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
These figures likely represent a grave undercount, as they only include incidents documented publicly. In many war-torn areas, communications are sparse.
Last year, it was reported that half of all women who lost their lives in maternal circumstances were in a conflict area. This underscores a horrifying trend.
In addition to the loss of life, these attacks are destroying critical infrastructure for mothers and babies, posing a long-term threat to community survival.
The Situation in Gaza
In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as a factor in genocide allegations.
Even after ceasefires, doctors report that women and children are still perishing from a lack of proper treatment, owing to severe deficits of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals were inaccessible.
“Direct shelling fired at the wards, operating rooms, and maternity wards,” says 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 maternity and neonatal facilities have been damaged or destroyed in Ukraine. Journalism from conflict zones describe births taking place in basements and skyrocketing stress leading to birth complications.
“Russia is targeting us deliberately,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The truth of the matter is, every facility can be under attack now,” comments a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris could impact a hospital.”
A Culture of Impunity
For the more than 676 million women living close to deadly warfare, there are minimal protections and even fewer war crimes prosecutions for those assaulting reproductive health.
This void of justice has fostered a “atmosphere of lawlessness,” explains a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by preventing births.”
Additional Hotspots
In El Fasher, the area had been cut off from humanitarian aid long before the hospital attack, with malnutrition spiking dangerously, 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 damaged a maternity hospital, killing mothers, babies, and nurses.
In Myanmar, clinics have been attacked 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 preventable with routine care, but war collapses medical infrastructure. 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 speaks to a wider and more disturbing trend: the use of attacks on medical facilities as a tool for terror and to destroy community bonds,” says a legal researcher.
“Safeguards are not guaranteed 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.”
