Thirty women were seeking shelter in a childbirth facility in El Fasher, Sudan, as the slaughter began. Some had just delivered their newborns, while others were experiencing childbirth.
On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “The sounds of screaming reached me of women and children,” he recounts. “They executed everybody inside the hospital. We who were able to escape, did so.”
This appalling incident stands as among the worst examples in the ongoing war tearing the North African nation apart. Combatants stormed the facility, allegedly slaughtering 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 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 are signatories to the Geneva conventions, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Expectant mothers are highly exposed due to their need for locally available medical care.
Data analysis and investigations uncover an alarming level of violence: nearly 300 incidents targeting or hindering maternity care facilities, staff, and pregnant women over the last three years, including at least 119 direct strikes on hospitals and delivery wards.
“This is not natural consequences of war. They represent a deliberate strategy of violence against reproduction.”
The majority of these incidents have happened in regions embroiled in intense conflict, where a vast number of expectant mothers are stranded.
Deaths have occurred, denied medical attention, or compelled to deliver in dangerous and unsanitary conditions. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 abducted, and 101 detained—sometimes during medical procedures.
The Global Crisis for Mothers and Newborns
These figures likely represent a substantial underreporting, as they only include incidents documented publicly. In many conflict zones, reporting is limited.
Last year, findings indicated that one in two mothers who perished while pregnant or giving birth were in a conflict area. This underscores a catastrophic reality.
Beyond killing women and staff, these attacks are obliterating maternal and neonatal care facilities, creating a grave danger to community survival.
Conditions within Gaza
In Gaza, the ruinous consequences on reproductive health rights has been cited by a UN commission as a factor in accusations of genocidal acts.
Despite periods of calm, doctors report that women and children succumb from inadequate care, owing to severe deficits of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals were out of reach.
“Direct shelling fired at the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or trying to alter birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 childbirth centers have been attacked and rendered unusable in Ukraine. Reports from frontline hospitals describe births occurring in shelters and extreme psychological pressure leading to problems during delivery.
“We are being singled out,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“The truth of the matter is, every facility faces the threat of assault,” comments a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”
Accountability Evaporates
For the over half a billion females living close to deadly warfare, there are minimal protections and rare trials for atrocities for those attacking childbirth services.
This absence of consequences has created a “atmosphere of lawlessness,” explains a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, are potentially acts of genocide by preventing births.”
Additional Hotspots
In El Fasher, the area lacked access to 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 inability to report from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, resulting in tragic loss of life.
In Myanmar, hospitals have come under fire 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
Most maternal deaths are averted with basic healthcare, but war collapses medical infrastructure. Rights groups note that anxiety is forcing women away from facilities once considered safe, resulting in risky home births without skilled assistance.
“If maternity hospitals are being deliberately targeted points toward a larger and alarming strategy: the use of violence against hospitals as a tool for terror and to destroy community bonds,” says a legal researcher.
“There is no absolute protection 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 often been cited as an excuse.”
