Dozens of women had taken refuge in a maternity hospital in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, while others were experiencing childbirth.
Working that night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “I heard the screams of women and children,” he recounts. “They executed everybody inside the hospital. Those who could run, fled.”
This appalling incident stands as among the worst examples in the ongoing war tearing the North African nation apart. Combatants raided the hospital, leaving dead more than 460 patients and their companions.
Rights organizations have labeled it “an unspeakable atrocity,” and a prime example of the vanishing safeguards for civilians caught in conflict zones in multiple global hotspots.
A Record of Violence Against Maternal Care
Although world powers have agreed to the Geneva conventions, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Women undergoing childbirth are highly exposed due to their reliance on locally available medical care.
Data analysis and investigations uncover 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 targeted attacks against hospitals and delivery wards.
“This is not natural consequences of war. They constitute a pattern of reproductive violence.”
The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where hundreds of thousands of women bearing children are confined.
Deaths have occurred, prevented from accessing care, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been murdered, 15 taken hostage, and 101 detained—sometimes during medical procedures.
A Worldwide Emergency for Mothers and Newborns
These figures likely represent a grave undercount, as they are limited to incidents documented publicly. In many war-torn areas, reporting is limited.
Last year, findings indicated that half of all women who lost their lives in maternal circumstances resided in a war zone. This underscores a catastrophic reality.
Apart from fatalities, these attacks are obliterating critical infrastructure for mothers and babies, posing a long-term threat to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the catastrophic impact on reproductive health rights has been cited by a UN commission as one reason behind declaring certain actions a genocide.
Following truces, doctors report that women and children succumb from medical shortages, owing to severe deficits of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals were inaccessible.
“We’ve had rockets targeting the wards, operating rooms, and maternity wards,” states 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 hospitals for mothers and babies have been struck and ruined in Ukraine. Journalism from conflict zones describe births forced underground and extreme psychological pressure leading to birth complications.
“Russia is targeting us deliberately,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“In fact, every facility can be under attack now,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”
Accountability Evaporates
For the more than 676 million women living near active conflicts, there are minimal protections and a stark lack of legal accountability for those attacking childbirth services.
This absence of consequences has led to a “atmosphere of lawlessness,” says a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, may constitute acts of genocide by preventing births.”
Additional Hotspots
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 scarce because of a communication blackout from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, resulting in tragic loss of life.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have suffered violence over the past two years of civil war.
The End of Safe Deliveries
Most maternal deaths are preventable with routine care, but war destroys healthcare networks. Rights groups note that anxiety is forcing women away from facilities once considered safe, pushing them toward risky home births devoid of emergency care.
“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,” notes 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 ‘harmful to the enemy’, which has increasingly been used as a justification.”
