A group of thirty mothers were seeking shelter in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Some had just delivered their newborns, while others were actively in labor.
Working that night, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “I heard the screams of women and children,” he recounts. “They were killing everyone inside the hospital. Survival meant running for your life.”
This horrifying event stands as one of the most shocking examples in the two-year civil war tearing the African nation apart. Militiamen forced their way into the building, leaving dead more than 460 individuals receiving care and their families.
Rights organizations have labeled it “a crime beyond words,” and a clear case of the deteriorating protection for civilians caught in conflict zones in multiple global hotspots.
An Unprecedented Assault On Childbirth Services
Despite every significant nation are signatories to the Geneva conventions, which obligate them to protect civilians, the past year has seen a record number of assaults against medical infrastructure. Expectant mothers are particularly at risk due to their dependence on locally available medical care.
Data analysis and investigations show an unprecedented scale of attacks: 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 incidents do not represent natural consequences of war. They represent a systematic assault on childbirth.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where countless of women bearing children are confined.
Deaths have occurred, denied medical attention, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 kidnapped, and 101 detained—sometimes while assisting births.
A Worldwide Emergency for Mothers and Newborns
The numbers are probably a grave undercount, as they capture solely incidents covered by the media. In many areas of fighting, information is scarce.
Last year, analysis showed that one in two mothers who lost their lives in maternal circumstances resided in a war zone. This underscores a devastating pattern.
Beyond killing women and staff, these attacks are obliterating critical infrastructure for mothers and babies, posing a long-term threat to community survival.
Conditions within Gaza
In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as one reason behind genocide allegations.
Despite periods of calm, doctors report that women and children succumb from inadequate care, owing to severe deficits of medicine and equipment. Accounts describe women giving birth in rubble because hospitals could not be reached.
“Direct shelling targeting the wards, operating rooms, and maternity wards,” says 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 childbirth centers have been struck and ruined in Ukraine. Accounts from embattled medical centers describe births taking place in basements and skyrocketing stress leading to problems during delivery.
“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.
“In fact, every facility faces the threat of assault,” comments a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris could impact a hospital.”
Accountability Evaporates
For the more than 676 million women living close to deadly warfare, there are minimal protections and even fewer war crimes prosecutions for those attacking childbirth services.
This void of justice has led to a “atmosphere of lawlessness,” argues a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, can be understood as acts of genocide by destroying a group's future.”
Additional Hotspots
In El Fasher, the area was isolated from 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 inability to report 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 faced detention, death, or harm over the past two years of civil war.
The Collapse of Safe Childbirth
The majority of childbirth fatalities are averted with basic healthcare, but war shatters health systems. Rights groups note that anxiety is forcing women away from facilities once considered safe, pushing them toward risky home births lacking professional help.
“The deliberate attack on maternity wards points toward a larger and alarming strategy: the use of violence against hospitals as a weapon to spread fear and to destroy community bonds,” notes 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.”
