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 experiencing childbirth.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “There were cries of women and children,” he explains. “They were killing everyone inside the hospital. Those who could run, fled.”
This appalling incident stands as among the worst examples in the ongoing war tearing the African nation apart. Combatants raided the hospital, allegedly slaughtering more than 460 patients and their companions.
Rights organizations have labeled it “an unspeakable atrocity,” and a stark illustration of the collapse in safety for civilians trapped in war-torn areas in multiple global hotspots.
An Unprecedented Assault On Childbirth Services
While all major powers are signatories to the international laws of war, which commit them to defending civilians, the past year has experienced a historic high of attacks on healthcare systems. Women undergoing childbirth are particularly at risk due to their dependence on locally available medical care.
Data analysis and investigations uncover 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.
“These incidents do not represent inevitable outcomes of conflict. They constitute a pattern of reproductive violence.”
The majority of these incidents have happened in regions embroiled in intense conflict, where a vast number of pregnant women are trapped.
Mothers have lost their lives, blocked from reaching help, or compelled to deliver in deplorable situations. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 kidnapped, and 101 detained—sometimes during medical procedures.
The Global Crisis in Maternal Health
These figures likely represent a significant underestimate, as they are limited to incidents covered by the media. In many areas of fighting, communications are sparse.
Last year, analysis showed that one in two mothers who died during pregnancy or childbirth were in a conflict area. This underscores a horrifying trend.
Beyond killing women and staff, these attacks are wrecking critical infrastructure for mothers and babies, jeopardizing the future to demographic stability.
The Situation in Gaza
In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as a factor in genocide allegations.
Following truces, doctors report that women and children succumb from inadequate care, owing to critical shortages of medicine and equipment. Agencies have reported women giving birth in rubble 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 rejected deliberately targeting maternity care or trying to alter birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 hospitals for mothers and babies have been struck and ruined in Ukraine. Accounts from embattled medical centers describe births forced underground and extreme psychological pressure 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 faces the threat of assault,” comments a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris may hit a hospital.”
A Culture of Impunity
For the over half a billion females living near active conflicts, there are minimal protections and rare trials for atrocities for those attacking childbirth services.
This lack of accountability has fostered a “atmosphere of lawlessness,” says a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, are potentially 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 spiking dangerously, 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, medical facilities have been bombed and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The End of Safe Deliveries
Most maternal deaths are avoidable with standard medicine, but war collapses medical infrastructure. Rights groups note that fear is now driving women away from facilities once considered safe, pushing them toward risky home births devoid of emergency care.
“When childbirth centers become intentional targets speaks to a larger and alarming strategy: the use of violence against hospitals as a tool for terror and to tear apart the social fabric,” observes a legal researcher.
“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘harmful to the enemy’, which has often been cited as an excuse.”
