Thirty women were huddled for safety in a childbirth facility in El Fasher, Sudan, as the slaughter began. Several had recently given birth, while others were in the midst of 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. “I heard the screams of women and children,” he explains. “They executed everybody inside the hospital. We who were able to escape, did so.”
This horrifying event stands as a particularly egregious examples in the two-year civil war tearing the African nation apart. Armed soldiers raided the hospital, allegedly slaughtering more than 460 patients and their companions.
Rights organizations have labeled it “a crime beyond words,” and a prime example of the vanishing safeguards for civilians trapped in war-torn areas in multiple global hotspots.
A Record of Violence On Childbirth Services
While all major powers are signatories to the international laws of war, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of assaults against medical infrastructure. Expectant mothers are highly exposed due to their dependence on locally available medical care.
Data analysis and investigations uncover an unprecedented scale of attacks: nearly 300 incidents targeting or hindering places and people associated with childbirth over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“These incidents do not represent inevitable outcomes of conflict. They constitute a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where a vast number of women bearing children are confined.
Deaths have occurred, denied medical attention, or compelled to deliver in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 taken hostage, and 101 detained—sometimes during medical procedures.
The Global Crisis for Mothers and Newborns
Statistics are thought to be a significant underestimate, as they only include incidents reported in news outlets. In many war-torn areas, information is scarce.
Last year, it was reported that one in two mothers who perished while pregnant or giving birth lived amidst hostilities. This underscores a catastrophic reality.
Beyond killing women and staff, these attacks are wrecking hospitals and wards, creating a grave danger to demographic stability.
Conditions within Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as one reason behind genocide allegations.
Following truces, doctors report that women and children continue to die from medical shortages, owing to desperate lacks of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals could not be reached.
“We’ve had rockets 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 hospitals for mothers and babies have been struck and ruined in Ukraine. Reports from frontline hospitals describe births taking place in basements and skyrocketing stress leading to birth complications.
“The attacks on us are intentional,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.
“The truth of the matter is, every facility is now a potential target,” states a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
A Culture of Impunity
For the hundreds of millions of women living close to deadly warfare, there are minimal protections and rare trials for atrocities for those targeting maternity care.
This void of justice has fostered a “culture of impunity,” argues a human rights lawyer. “Attacks on reproductive healthcare, 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 restricted due to 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
The majority of childbirth fatalities are avoidable with standard medicine, 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.
“The deliberate attack on maternity wards indicates a broader and more sinister pattern: the use of violence against hospitals as a weapon to spread fear and to break societal cohesion,” says a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘militarily advantageous’, which has often been cited as an excuse.”
