Dozens of women were huddled for safety in a maternity hospital in El Fasher, Sudan, as the slaughter began. Some had just delivered their newborns, while others were experiencing childbirth.
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 states. “They were killing everyone inside the hospital. Those who could run, fled.”
This brutal attack stands as among the worst examples in the two-year civil war tearing the North African nation apart. Combatants raided the hospital, allegedly slaughtering more than 460 patients and their companions.
Rights organizations have called it “an unspeakable atrocity,” and a prime example of the deteriorating protection for civilians caught in conflict zones in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence Against Maternal Care
Despite every significant nation have agreed to the Geneva conventions, which require them to safeguard civilians, the past year has seen a record number of attacks on healthcare systems. Expectant mothers are exceptionally vulnerable due to their need for locally available medical care.
Research and compiled data uncover an shocking trend: nearly 300 attacks on and disruptions to 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 natural consequences of war. They represent a pattern of reproductive violence.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where countless of pregnant women are trapped.
Women have been killed, blocked from reaching help, or compelled to deliver in deplorable situations. The data also indicates that at least 68 maternal health workers have been killed, 15 abducted, and 101 taken into custody—sometimes during medical procedures.
A Worldwide Emergency for Mothers and Newborns
Statistics are thought to be a substantial underreporting, as they are limited to incidents covered by the media. In many conflict zones, reporting is limited.
Last year, it was reported that one in two mothers who died during pregnancy or childbirth resided in a war zone. This underscores a catastrophic reality.
Beyond killing women and staff, these attacks are wrecking maternal and neonatal care facilities, jeopardizing the future to community survival.
The Situation in Gaza
In Gaza, the ruinous consequences on reproductive health rights has been cited by a UN commission as part of the basis for genocide allegations.
Following truces, doctors report that women and children continue to die from inadequate care, owing to critical shortages of medicine and equipment. Agencies have reported women having children by the roadside because hospitals could not be reached.
“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 denied deliberately targeting maternity care or aiming to influence birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 hospitals for mothers and babies have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and skyrocketing stress leading to birth complications.
“Russia is targeting us deliberately,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The truth of the matter is, every facility can be under attack now,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris could impact a hospital.”
Accountability Evaporates
For the over half a billion females living near active conflicts, there are few safeguards and even fewer war crimes prosecutions for those targeting maternity care.
This void of justice has created a “environment where anything goes,” argues a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, are potentially acts of genocide by preventing births.”
Additional Hotspots
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 limited by a lack of access from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, causing fatalities among patients and staff.
In Myanmar, clinics have been attacked and dozens of midwives and patients have suffered violence 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 destroys healthcare networks. Rights groups note that fear is now driving women away from facilities once considered safe, resulting in risky home births lacking professional help.
“If maternity hospitals are being deliberately targeted indicates a wider and more disturbing trend: the use of attacks on medical facilities as a tool for terror and to destroy community bonds,” notes a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘prejudicial to the opposing side’, which has often been cited as an excuse.”
