Thirty women were seeking shelter in a childbirth facility in El Fasher, Sudan, as the slaughter began. Some had just delivered their newborns, while others were actively in labor.
On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “I heard the screams of women and children,” he explains. “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. Armed soldiers 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 clear case of the vanishing safeguards for civilians living amidst warfare in multiple global hotspots.
An Unprecedented Assault Against Maternal Care
Despite every significant nation have agreed to the Geneva conventions, which obligate them to protect civilians, the past year has seen a record number of violence targeting health services. Women undergoing childbirth are highly exposed due to their dependence on locally available medical care.
Data analysis and investigations uncover 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 targeted attacks against hospitals and delivery wards.
“This is not standard wartime hazards. They form a pattern of reproductive violence.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where hundreds of thousands of expectant mothers are stranded.
Women have been killed, denied medical attention, or compelled to deliver in dangerous and unsanitary conditions. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 kidnapped, and 101 detained—sometimes during medical procedures.
A Worldwide Emergency in Maternal Health
These figures likely represent a substantial underreporting, as they are limited to incidents reported in news outlets. In many areas of fighting, reporting is limited.
Last year, analysis showed that one in two mothers who lost their lives in maternal circumstances resided in a war zone. This underscores a devastating pattern.
Apart from fatalities, these attacks are destroying hospitals and wards, jeopardizing the future to societal repopulation and recovery.
The Situation in Gaza
In Gaza, the ruinous consequences on reproductive health rights has been cited by a UN commission as part of the basis for accusations of genocidal acts.
Following truces, doctors report that women and children are still perishing from inadequate care, owing to desperate lacks of medicine and equipment. Agencies have reported women having children by the roadside because hospitals could not be reached.
“We’ve had rockets targeting the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or seeking to affect birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities have been attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births occurring in shelters and skyrocketing stress leading to problems during delivery.
“We are being singled out,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The reality is, every facility faces the threat of assault,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris could impact a hospital.”
A Culture of Impunity
For the hundreds of millions of women living within range of fighting, there are few safeguards and a stark lack of legal accountability for those assaulting reproductive health.
This lack of accountability has fostered a “environment where anything goes,” says a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, can be understood as acts of genocide by destroying a group's future.”
Additional Hotspots
In El Fasher, the area was isolated from humanitarian aid long before the hospital attack, with malnutrition increasing drastically, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is restricted due to a lack of access from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, killing mothers, babies, and nurses.
In Myanmar, hospitals have come under fire and dozens of midwives and patients have faced detention, death, or harm over the past two years of civil war.
The Collapse of Safe Childbirth
A large proportion of mother deaths are averted with basic healthcare, but war shatters health systems. Rights groups note that terror is compelling women away from facilities once considered safe, leading them to risky home births devoid of emergency care.
“When childbirth centers become intentional targets points toward a broader and more sinister pattern: the use of violence against hospitals as a means of intimidation and to break societal cohesion,” observes 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.”
