A group of thirty mothers had taken refuge 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 states. “A massacre was taking place inside the hospital. Those who could run, fled.”
This appalling incident stands as one of the most shocking examples in the two-year civil war tearing the African nation apart. Armed soldiers raided the hospital, reportedly killing more than 460 individuals receiving care and their families.
Rights organizations have called it “an unspeakable atrocity,” and a prime example of the vanishing safeguards for civilians caught in conflict zones in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
An Unprecedented Assault On Childbirth Services
Although world powers have agreed to the Geneva conventions, which obligate them to protect civilians, the past year has experienced a historic high of attacks on healthcare systems. Expectant mothers are exceptionally vulnerable due to their dependence on locally available medical care.
An investigation of records show 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 targeted attacks against hospitals and delivery wards.
“This is not standard wartime hazards. They form a deliberate strategy of violence against reproduction.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where countless of women bearing children are confined.
Deaths have occurred, denied medical attention, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 abducted, and 101 detained—sometimes while assisting births.
A Worldwide Emergency for Mothers and Newborns
Statistics are thought to be a significant underestimate, as they are limited to incidents covered by the media. In many conflict zones, information is scarce.
Last year, analysis showed that one in two mothers who lost their lives in maternal circumstances resided in a war zone. This underscores a catastrophic reality.
Beyond killing women and staff, these attacks are obliterating hospitals and wards, posing a long-term threat 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 part of the basis for declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children continue to die from medical shortages, owing to critical shortages of medicine and equipment. Agencies have reported women having children by the roadside because hospitals were inaccessible.
“We’ve had rockets fired at the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or aiming to influence birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 childbirth centers have been struck and ruined in Ukraine. Journalism from conflict zones describe births occurring in shelters and extreme psychological pressure leading to birth complications.
“The attacks on us are intentional,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The truth of the matter is, every facility can be under attack now,” comments a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris may hit a hospital.”
Accountability Evaporates
For the hundreds of millions of women living close to deadly warfare, there are minimal protections and even fewer war crimes prosecutions for those attacking childbirth services.
This absence of consequences has created a “atmosphere of lawlessness,” explains 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 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 restricted due to a communication blackout from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, resulting in tragic loss of life.
In Myanmar, clinics have been attacked 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
The majority of childbirth fatalities are averted with basic healthcare, but war destroys healthcare networks. Rights groups note that anxiety is forcing women away from facilities once considered safe, pushing them toward risky home births lacking professional help.
“If maternity hospitals are being deliberately targeted speaks to a wider and more disturbing trend: the use of violence against hospitals as a weapon to spread fear 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 can lose their protected status if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”
