Dozens of women were seeking shelter in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. Some had just delivered their newborns, while others were actively in labor.
Present at the hospital after dark, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “The sounds of screaming reached me of women and children,” he recounts. “A massacre was taking place inside the hospital. We who were able to escape, did so.”
This brutal attack stands as a particularly egregious examples in the protracted internal conflict tearing the African nation apart. Combatants forced their way into the building, leaving dead more than 460 individuals receiving care and their families.
Rights organizations have described it as “a crime beyond words,” and a prime example of the collapse in safety for civilians trapped in war-torn areas in several nations at war.
An Unprecedented Assault Against Maternal Care
Despite every significant nation 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.
Research and compiled data reveal an shocking trend: nearly 300 attacks on and disruptions to 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 standard wartime hazards. They constitute a systematic assault on childbirth.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where hundreds of thousands of women bearing children are confined.
Mothers have lost their lives, prevented from accessing care, or made to have their babies in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been slain, 15 kidnapped, and 101 taken into custody—sometimes while assisting births.
A Worldwide Emergency in Maternal Health
Statistics are thought to be a grave undercount, as they capture solely incidents covered by the media. In many war-torn areas, communications are sparse.
Last year, analysis showed that 50% of women who perished while pregnant or giving birth lived amidst hostilities. This underscores a devastating pattern.
Beyond killing women and staff, these attacks are wrecking critical infrastructure for mothers and babies, creating a grave danger 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 a factor in genocide allegations.
Even after ceasefires, doctors report that women and children succumb from medical shortages, owing to desperate lacks of medicine and equipment. Accounts describe women having children by the roadside because hospitals were inaccessible.
“We’ve had rockets fired at the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has rejected deliberately targeting maternity care or aiming to influence birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 childbirth centers have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and extreme psychological pressure leading to problems during delivery.
“Russia is targeting us deliberately,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“In fact, every facility is now a potential target,” notes a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris could impact a hospital.”
Accountability Evaporates
For the hundreds of millions of women living within range of fighting, there are minimal protections and rare trials for atrocities for those targeting maternity care.
This absence of consequences has created a “environment where anything goes,” explains a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, may constitute acts of genocide by destroying a group's future.”
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 communication blackout from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, causing fatalities among patients and staff.
In Myanmar, hospitals have come under fire 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 preventable with routine care, but war collapses medical infrastructure. Rights groups note that fear is now driving women away from facilities once considered safe, pushing them toward risky home births devoid of emergency care.
“When childbirth centers become intentional targets speaks to a larger and alarming strategy: the use of violence against hospitals as a weapon to spread fear and to tear apart the social fabric,” observes 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 often been cited as an excuse.”
