Thirty women 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, Abdo-Rabo Ahmed, managed to survive the ordeal. “The sounds of screaming reached me of women and children,” he explains. “A massacre was taking place inside the hospital. Those who could run, fled.”
This horrifying event stands as a particularly egregious examples in the ongoing war tearing the African nation apart. Militiamen raided the hospital, reportedly killing more than 460 innocent people inside.
Rights organizations have labeled it “an act of unspeakable brutality,” and a stark illustration of the deteriorating protection for civilians trapped in war-torn areas in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.
A Record of Violence On Childbirth Services
Despite every significant nation have signed the Geneva conventions, which require them to safeguard civilians, the past year has seen a record number of violence targeting health services. Mothers in labor are highly exposed due to their need for locally available medical care.
Data analysis and investigations reveal 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.
“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 hundreds of thousands of pregnant women are trapped.
Mothers have lost their lives, denied medical attention, or made to have their babies in dangerous and unsanitary conditions. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 kidnapped, and 101 taken into custody—sometimes during medical procedures.
A Worldwide Emergency for Mothers and Newborns
The numbers are probably a significant underestimate, as they capture solely incidents documented publicly. In many areas of fighting, communications are sparse.
Last year, findings indicated that 50% of women who died during pregnancy or childbirth resided in a war zone. This underscores a horrifying trend.
In addition to the loss of life, these attacks are obliterating hospitals and wards, posing a long-term threat to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as part of the basis for accusations of genocidal acts.
Despite periods of calm, doctors report that women and children are still perishing from a lack of proper treatment, owing to severe deficits of medicine and equipment. Accounts describe women having children by the roadside because hospitals were inaccessible.
“Direct shelling hitting 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 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. Reports from frontline hospitals describe births forced underground and extreme psychological pressure leading to maternal health issues.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“In fact, every facility faces the threat of assault,” states a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”
A Culture of Impunity
For the over half a billion females living close to deadly warfare, there are minimal protections and rare trials for atrocities for those assaulting reproductive health.
This lack of accountability has fostered a “atmosphere of lawlessness,” argues a human rights lawyer. “Assaults against maternal services, 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 limited by a communication blackout from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, 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 Collapse of Safe Childbirth
A large proportion of mother deaths are averted with basic healthcare, but war destroys healthcare networks. Rights groups note that anxiety is forcing women away from facilities once considered safe, leading them to risky home births lacking professional help.
“The deliberate attack on maternity wards points toward a wider and more disturbing trend: the use of attacks on medical facilities as a tool for terror and to destroy community bonds,” observes a legal researcher.
“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘harmful to the enemy’, which has now become a standard defence.”
