Thirty women had taken refuge in a childbirth facility in El Fasher, Sudan, as the slaughter began. Some had just delivered their newborns, while others were actively in labor.
Present at the hospital after dark, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “I heard the screams of women and children,” he recounts. “They executed everybody inside the hospital. We who were able to escape, did so.”
This brutal attack stands as one of the most shocking examples in the ongoing war tearing the North African nation apart. Militiamen raided the hospital, allegedly slaughtering more than 460 patients and their companions.
Rights organizations have called it “an act of unspeakable brutality,” and a prime example of the vanishing safeguards 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 experienced a historic high of assaults against medical infrastructure. Expectant mothers are particularly at risk due to their need for locally available medical care.
An investigation of records uncover an shocking trend: nearly 300 attacks on and disruptions to places and people associated with childbirth over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These incidents do not represent inevitable outcomes of conflict. They represent a deliberate strategy of violence against reproduction.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where hundreds of thousands of expectant mothers are stranded.
Women have been killed, prevented from accessing care, or forced to give birth in dangerous and unsanitary conditions. The data also indicates that at least 68 maternal health workers have been killed, 15 taken hostage, and 101 detained—sometimes during medical procedures.
The Global Crisis for Mothers and Newborns
The numbers are probably a substantial underreporting, as they capture solely incidents documented publicly. In many conflict zones, reporting is limited.
Last year, analysis showed that 50% of women who lost their lives in maternal circumstances resided in a war zone. This underscores a devastating pattern.
Beyond killing women and staff, these attacks are obliterating hospitals and wards, creating a grave danger to societal repopulation and recovery.
The Situation in Gaza
In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as one reason behind accusations of genocidal acts.
Following truces, 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 could not be reached.
“We’ve had rockets targeting the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or trying to alter birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 hospitals for mothers and babies have been attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births forced underground and skyrocketing stress leading to problems during delivery.
“The attacks on us are intentional,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“The truth of the matter 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.”
Accountability Evaporates
For the more than 676 million women living within range of fighting, there are minimal protections and rare trials for atrocities for those attacking childbirth services.
This void of justice has fostered a “environment where anything goes,” explains a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by destroying a group's future.”
Additional Hotspots
In El Fasher, the area lacked access to 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 inability to report from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, killing mothers, babies, and nurses.
In Myanmar, hospitals have come under fire and dozens of midwives and patients have suffered violence over the past two years of civil war.
The Collapse of Safe Childbirth
A large proportion of mother deaths are preventable with routine care, but war shatters health systems. Rights groups note that terror is compelling women away from facilities once considered safe, resulting in risky home births without skilled assistance.
“If maternity hospitals are being deliberately targeted speaks to a wider and more disturbing trend: the use of attacks on medical facilities as a weapon to spread fear and to tear apart the social fabric,” observes a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘militarily advantageous’, which has increasingly been used as a justification.”
