A group of thirty mothers had taken refuge in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. Several had recently given birth, while others were in the midst of labor.
On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “The sounds of screaming reached me of women and children,” he explains. “They executed everybody inside the hospital. Those who could run, fled.”
This brutal attack stands as a particularly egregious examples in the protracted internal conflict tearing the African nation apart. Armed soldiers forced their way into the building, leaving dead more than 460 innocent people inside.
Rights organizations have described it as “a crime beyond words,” and a clear case of the collapse in safety for civilians caught in conflict zones in multiple global hotspots.
A Record of Violence Against Maternal Care
Despite every significant nation are signatories to the international laws of war, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Women undergoing childbirth are exceptionally vulnerable due to their reliance on locally available medical care.
An investigation of records uncover an unprecedented scale of attacks: nearly 300 incidents targeting or hindering maternity care facilities, staff, and pregnant women over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“This is not natural consequences of war. They form a deliberate strategy of violence against reproduction.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where a vast number of women bearing children are confined.
Women have been killed, denied medical attention, or compelled to deliver in dangerous and unsanitary conditions. The data also indicates that at least 68 maternal health workers have been killed, 15 kidnapped, and 101 taken into custody—sometimes while assisting births.
The Global Crisis for Mothers and Newborns
Statistics are thought to be a substantial underreporting, as they only include incidents documented publicly. In many war-torn areas, information is scarce.
Last year, analysis showed that half of all women who died during pregnancy or childbirth resided in a war zone. This underscores a devastating pattern.
Beyond killing women and staff, these attacks are destroying hospitals and wards, posing a long-term threat to demographic stability.
The Situation in 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.
Following truces, doctors report that women and children succumb from medical shortages, owing to critical shortages of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals could not be reached.
“Our facility has endured missile strikes hitting the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or seeking to affect birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 childbirth centers have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births forced underground and skyrocketing stress leading to problems during delivery.
“We are being singled out,” asserts 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 faces the threat of assault,” comments a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris could impact a hospital.”
A Culture of Impunity
For the more than 676 million women living close to deadly warfare, there are few safeguards and even fewer war crimes prosecutions for those assaulting reproductive health.
This void of justice has led to a “environment where anything goes,” says a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, are potentially acts of genocide by destroying a group's future.”
Additional Hotspots
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 limited by a lack of access from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, killing mothers, babies, and nurses.
In Myanmar, clinics have been attacked and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The End of Safe Deliveries
A large proportion of mother deaths are preventable with routine care, but war shatters health systems. Rights groups note that fear is now driving women away from facilities once considered safe, leading them to risky home births devoid of emergency care.
“The deliberate attack on maternity wards indicates a larger and alarming strategy: the use of violence against hospitals as a means of intimidation and to tear apart the social fabric,” observes 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 ‘militarily advantageous’, which has often been cited as an excuse.”
