A group of thirty mothers had taken refuge in a maternity hospital in El Fasher, Sudan, when the massacre started. Among them were new mothers, while others were actively in labor.
Present at the hospital after dark, 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 explains. “They executed everybody inside the hospital. Survival meant running for your life.”
This appalling incident stands as one of the most shocking examples in the protracted internal conflict tearing the African nation apart. Armed soldiers forced their way into the building, allegedly slaughtering more than 460 patients and their companions.
Rights organizations have called it “a crime beyond words,” and a stark illustration of the vanishing safeguards for civilians living amidst warfare in multiple global hotspots.
An Unprecedented Assault On Childbirth Services
Despite every significant nation have agreed to the Geneva conventions, which obligate them to protect civilians, the past year has seen a record number of violence targeting health services. Mothers in labor are exceptionally vulnerable due to their dependence on locally available medical care.
An investigation of records reveal an alarming level of violence: nearly 300 violent acts against places and people associated with childbirth over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“These are not natural consequences of war. 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 expectant mothers are stranded.
Women have been killed, blocked from reaching help, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 kidnapped, and 101 arrested—sometimes while assisting births.
The Global Crisis in Maternal Health
These figures likely represent a substantial underreporting, as they capture solely incidents reported in news outlets. In many conflict zones, information is scarce.
Last year, findings indicated that 50% of women who lost their lives in maternal circumstances were in a conflict area. This underscores a catastrophic reality.
In addition to the loss of life, these attacks are wrecking hospitals and wards, creating a grave danger to societal repopulation and recovery.
The Situation in Gaza
In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as part of the basis for accusations of genocidal acts.
Even after ceasefires, doctors report that women and children are still perishing from medical shortages, owing to desperate lacks of medicine and equipment. Accounts describe women having children by the roadside 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.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities have been struck and ruined in Ukraine. Journalism from conflict zones describe births taking place in basements and skyrocketing stress leading to maternal health issues.
“The attacks on us are intentional,” 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,” notes 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 hundreds of millions of women living near active conflicts, there are minimal protections and a stark lack of legal accountability for those attacking childbirth services.
This void of justice has fostered a “environment where anything goes,” argues a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, are potentially acts of genocide by destroying a group's future.”
Other Conflict Zones
In El Fasher, the area had been cut off 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 hit a neonatal ward, 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 End of Safe Deliveries
The majority of childbirth fatalities are averted with basic healthcare, but war collapses medical infrastructure. Rights groups note that terror is compelling women away from facilities once considered safe, pushing them toward risky home births lacking professional help.
“When childbirth centers become intentional targets points toward a broader and more sinister pattern: the use of attacks on medical facilities as a tool for terror and to break societal cohesion,” says 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 increasingly been used as a justification.”
