A group of thirty mothers had taken refuge in a childbirth facility in El Fasher, Sudan, when the massacre started. Among them were new mothers, while others were actively in labor.
On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, became one of the few known survivors. “The sounds of screaming reached me of women and children,” he recounts. “A massacre was taking place inside the hospital. Those who could run, fled.”
This brutal attack stands as among the worst examples in the ongoing war tearing the African nation apart. Militiamen raided the hospital, leaving dead more than 460 individuals receiving care and their families.
Rights organizations have labeled it “an unspeakable atrocity,” and a stark illustration of the vanishing safeguards for civilians living amidst warfare in multiple global hotspots.
An Unprecedented Assault Against Maternal Care
Despite every significant nation are signatories to the international laws of war, which commit them to defending civilians, the past year has seen a record number of violence targeting health services. Expectant mothers are exceptionally vulnerable due to their reliance on locally available medical care.
An investigation of records reveal 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.
“This is not inevitable outcomes of conflict. They represent a pattern of reproductive violence.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where countless of women bearing children are confined.
Mothers have lost their lives, blocked from reaching help, or made to have their babies 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 in the act of delivering babies.
The Global Crisis for Mothers and Newborns
These figures likely represent a significant underestimate, as they only include incidents reported in news outlets. In many areas of fighting, information is scarce.
Last year, it was reported that 50% of women who perished while pregnant or giving birth were in a conflict area. This underscores a catastrophic reality.
Beyond killing women and staff, these attacks are obliterating hospitals and wards, jeopardizing the future to community survival.
The Situation in Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as a factor in declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children succumb from a lack of proper treatment, owing to severe deficits of medicine and equipment. Agencies have reported women having children by the roadside because hospitals were out of reach.
“Our facility has endured missile strikes targeting 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 trying to alter birthrates.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities have been attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births taking place in basements and skyrocketing stress leading to birth complications.
“The attacks on us are intentional,” 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 can be under attack now,” states a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
Accountability Evaporates
For the over half a billion females living close to deadly warfare, there are minimal protections and rare trials for atrocities for those attacking childbirth services.
This lack of accountability has led to a “culture of impunity,” explains a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, may constitute 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 rising sharply, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is scarce because of a lack of access from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, resulting in tragic loss of life.
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 averted with basic healthcare, but war collapses medical infrastructure. Rights groups note that fear is now driving women away from facilities once considered safe, pushing them toward 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 tool for terror and to destroy community bonds,” says a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has increasingly been used as a justification.”
