A group of thirty mothers had taken refuge in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. Several had recently given birth, while others were experiencing childbirth.
Working that night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “There were cries of women and children,” he recounts. “A massacre was taking place inside the hospital. We who were able to escape, did so.”
This horrifying event stands as among the worst examples in the protracted internal conflict tearing the African nation apart. Combatants stormed the facility, reportedly killing more than 460 individuals receiving care and their families.
Rights organizations have labeled it “a crime beyond words,” and a clear case of the vanishing safeguards for civilians trapped in war-torn areas in multiple global hotspots.
An Unprecedented Assault Against Maternal Care
Although world powers have agreed to the international laws of war, which commit them to defending civilians, the past year has seen a record number of assaults against medical infrastructure. Mothers in labor are highly exposed due to their need for locally available medical care.
Research and compiled data uncover an alarming level of violence: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“These are not standard wartime hazards. They represent a pattern of reproductive violence.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where a vast number of women bearing children are confined.
Deaths have occurred, prevented from accessing care, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 kidnapped, and 101 arrested—sometimes in the act of delivering babies.
A Worldwide Emergency for Mothers and Newborns
Statistics are thought to be a grave undercount, as they are limited to incidents reported in news outlets. In many conflict zones, reporting is limited.
Last year, findings indicated that half of all women who lost their lives in maternal circumstances were in a conflict area. This underscores a catastrophic reality.
Beyond killing women and staff, these attacks are obliterating critical infrastructure for mothers and babies, posing a long-term threat to community survival.
The Situation in Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as part of the basis for genocide allegations.
Despite periods of calm, doctors report that women and children continue to die from inadequate care, owing to desperate lacks of medicine and equipment. Agencies have reported women delivering babies amidst ruins because hospitals could not be reached.
“We’ve had rockets targeting 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. Journalism from conflict zones describe births taking place in basements and extreme psychological pressure leading to problems during delivery.
“The attacks on us are intentional,” asserts 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 is now a potential target,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”
A Culture of Impunity
For the more than 676 million women living near active conflicts, there are scarce guarantees and rare trials for atrocities for those targeting maternity care.
This void of justice has created a “environment where anything goes,” explains a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by hindering reproduction.”
Other Conflict Zones
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, medical facilities have been bombed and dozens of midwives and patients have faced detention, death, or harm over the past two years of civil war.
The End of Safe Deliveries
Most maternal deaths are averted with basic healthcare, but war collapses medical infrastructure. Rights groups note that terror is compelling 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 broader and more sinister pattern: the use of attacks on medical facilities as a weapon to spread fear and to destroy community bonds,” observes 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 increasingly been used as a justification.”
