Thirty women were seeking shelter in a maternity hospital in El Fasher, Sudan, when the massacre started. Several had recently given birth, while others were actively in labor.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “I heard the screams of women and children,” he recounts. “They were killing everyone inside the hospital. Survival meant running for your life.”
This appalling incident stands as one of the most shocking examples in the ongoing war tearing the African nation apart. Militiamen stormed the facility, allegedly slaughtering more than 460 individuals receiving care and their families.
Rights organizations have called it “an act of unspeakable brutality,” and a prime example of the deteriorating protection for civilians caught in conflict zones in several nations at war.
A Record of Violence On Childbirth Services
While all major powers have agreed to the international laws of war, which obligate them to protect civilians, the past year has seen a record number of violence targeting health services. Mothers in labor are exceptionally vulnerable due to their need for locally available medical care.
Data analysis and investigations reveal an alarming level of violence: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“These are not standard wartime hazards. They represent a systematic assault on childbirth.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where hundreds of thousands of pregnant women are trapped.
Deaths have occurred, denied medical attention, or made to have their babies in dangerous and unsanitary conditions. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been killed, 15 taken hostage, and 101 detained—sometimes in the act of delivering babies.
A Worldwide Emergency in Maternal Health
Statistics are thought to be a substantial underreporting, as they capture solely incidents reported in news outlets. In many war-torn areas, information is scarce.
Last year, findings indicated that half of all women who perished while pregnant or giving birth lived amidst hostilities. This underscores a horrifying trend.
Beyond killing women and staff, these attacks are obliterating maternal and neonatal care facilities, creating a grave danger to demographic stability.
Conditions within Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as one reason behind genocide allegations.
Despite periods of calm, doctors report that women and children continue to die from inadequate care, owing to desperate lacks of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals could not be reached.
“Direct shelling hitting the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or trying to alter birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 childbirth centers have been struck and ruined in Ukraine. Reports from frontline hospitals describe births taking place in basements and skyrocketing stress leading to birth complications.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“In fact, every facility is now a potential target,” states a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
Accountability Evaporates
For the more than 676 million women living within range of fighting, there are few safeguards and even fewer war crimes prosecutions for those attacking childbirth services.
This void of justice has led to a “culture of impunity,” explains a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, may constitute 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 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 damaged a maternity hospital, resulting in tragic loss of life.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have faced detention, death, or harm over the past two years of civil war.
The End of Safe Deliveries
A large proportion of mother deaths are averted with basic healthcare, but war collapses medical infrastructure. Rights groups note that terror is compelling women away from facilities once considered safe, pushing them toward risky home births devoid of emergency care.
“If maternity hospitals are being deliberately targeted indicates a broader and more sinister pattern: the use of attacks on medical facilities as a weapon to spread fear and to break societal cohesion,” says 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 often been cited as an excuse.”
