Thirty women were huddled for safety in a maternity hospital in El Fasher, Sudan, when the massacre started. Several had recently given birth, while others were experiencing childbirth.
On duty during that fateful 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 states. “They were killing everyone inside the hospital. Those who could run, fled.”
This brutal attack stands as among the worst examples in the ongoing war tearing the African nation apart. Armed soldiers raided the hospital, reportedly killing more than 460 innocent people inside.
Rights organizations have called it “a crime beyond words,” and a clear case of the vanishing safeguards for civilians trapped in war-torn areas in several nations at war.
A Record of Violence Against Maternal Care
Despite every significant nation have agreed to the Geneva conventions, which require them to safeguard civilians, the past year has seen a record number of violence targeting health services. Expectant mothers are particularly at risk due to their reliance on locally available medical care.
Data analysis and investigations uncover an unprecedented scale of attacks: nearly 300 incidents targeting or hindering maternity care facilities, staff, and pregnant women over the last three years, including at least 119 bombardments of hospitals and delivery wards.
“This is not inevitable outcomes of conflict. They constitute a pattern of reproductive violence.”
The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where hundreds of thousands of women bearing children are confined.
Women have been killed, blocked from reaching help, or compelled to deliver in deplorable situations. The data also indicates that at least 68 maternal health workers have been slain, 15 kidnapped, and 101 detained—sometimes while assisting births.
The Global Crisis in Maternal Health
Statistics are thought to be a grave undercount, as they are limited to incidents documented publicly. In many war-torn areas, communications are sparse.
Last year, it was reported that 50% of women who perished while pregnant or giving birth were in a conflict area. This underscores a horrifying trend.
In addition to the loss of life, these attacks are destroying maternal and neonatal care facilities, creating a grave danger 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 a factor in genocide allegations.
Even after ceasefires, doctors report that women and children continue to die from inadequate care, owing to desperate lacks of medicine and equipment. UN officials have relayed women delivering babies amidst ruins because hospitals were inaccessible.
“We’ve had rockets hitting the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or seeking to affect birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 maternity and neonatal facilities have been struck and ruined in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and extreme psychological pressure leading to maternal health issues.
“We are being singled out,” 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 faces the threat of assault,” comments a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris may hit a hospital.”
A Culture of Impunity
For the hundreds of millions of women living near active conflicts, there are few safeguards and a stark lack of legal accountability for those attacking childbirth services.
This void of justice has fostered a “atmosphere of lawlessness,” explains a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by destroying a group's future.”
Additional Hotspots
In El Fasher, the area had been cut off 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 limited by a inability to report from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, resulting in tragic loss of life.
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 End of Safe Deliveries
A large proportion of mother deaths are avoidable with standard medicine, but war collapses medical infrastructure. Rights groups note that terror is compelling women away from facilities once considered safe, pushing them toward risky home births devoid of emergency care.
“If maternity hospitals are being deliberately targeted speaks to a larger and alarming strategy: the use of violence against hospitals as a tool for terror and to break societal cohesion,” 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 ‘militarily advantageous’, which has often been cited as an excuse.”
