Dozens of women had taken refuge in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Some had just delivered their newborns, while others were actively in labor.
Working that night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “There were cries of women and children,” he recounts. “They were killing everyone inside the hospital. Survival meant running for your life.”
This appalling incident stands as a particularly egregious examples in the ongoing war tearing the North African nation apart. Militiamen forced their way into the building, allegedly slaughtering more than 460 innocent people inside.
Rights organizations have described it as “a crime beyond words,” and a stark illustration of the deteriorating protection for civilians living amidst warfare in multiple global hotspots.
A Record of Violence Against Maternal Care
Despite every significant nation have agreed to the international laws of war, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of assaults against medical infrastructure. Women undergoing childbirth are particularly at risk due to their need for locally available medical care.
An investigation of records show 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 are not inevitable outcomes of conflict. They represent a systematic assault on childbirth.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where hundreds of thousands of pregnant women are trapped.
Women have been killed, denied medical attention, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been killed, 15 abducted, and 101 taken into custody—sometimes while assisting births.
The Global Crisis for Mothers and Newborns
These figures likely represent a substantial underreporting, as they capture solely incidents documented publicly. In many conflict zones, information is scarce.
Last year, analysis showed that 50% of women who died during pregnancy or childbirth lived amidst hostilities. This underscores a catastrophic reality.
Apart from fatalities, these attacks are wrecking hospitals and wards, creating a grave danger to demographic stability.
Conditions within Gaza
In Gaza, the catastrophic impact on reproductive health rights has been cited by a UN commission as a factor in accusations of genocidal acts.
Even after ceasefires, doctors report that women and children continue to die from a lack of proper treatment, owing to desperate lacks of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals were inaccessible.
“Our facility has endured missile strikes fired at the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or seeking to affect birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities have been struck and ruined in Ukraine. Reports from frontline hospitals describe births occurring in shelters and extreme psychological pressure leading to problems during delivery.
“We are being singled out,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The reality is, every facility is now a potential target,” comments a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris can strike a hospital.”
Accountability Evaporates
For the more than 676 million women living near active conflicts, there are minimal protections and even fewer war crimes prosecutions for those assaulting reproductive health.
This absence of consequences has fostered a “environment where anything goes,” says a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, are potentially acts of genocide by preventing births.”
Other Conflict Zones
In El Fasher, the area had been cut off from humanitarian aid long before the hospital attack, with malnutrition rising sharply, 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 hit a neonatal ward, killing mothers, babies, and nurses.
In Myanmar, hospitals have come under fire and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The Collapse of Safe Childbirth
The majority of childbirth fatalities are avoidable with standard medicine, but war shatters health systems. Rights groups note that anxiety is forcing women away from facilities once considered safe, pushing them toward risky home births devoid of emergency care.
“If maternity hospitals are being deliberately targeted points toward a broader and more sinister pattern: the use of violence against hospitals as a means of intimidation and to tear apart the social fabric,” says 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 often been cited as an excuse.”
