Dozens of women had taken refuge in a maternity hospital in El Fasher, Sudan, when the massacre started. Among them were new mothers, 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. “I heard the screams of women and children,” he recounts. “They executed everybody inside the hospital. Survival meant running for your life.”
This horrifying event stands as one of the most shocking examples in the ongoing war tearing the African nation apart. Armed soldiers forced their way into the building, allegedly slaughtering more than 460 innocent people inside.
Rights organizations have described it as “a crime beyond words,” and a clear case of the collapse in safety for civilians living amidst warfare in several nations at war.
An Unprecedented Assault Against Maternal Care
Although world powers have agreed to the international laws of war, which obligate them to protect civilians, the past year has experienced a historic high of attacks on healthcare systems. Expectant mothers are highly exposed due to their dependence on locally available medical care.
Research and compiled data reveal 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.
“This is not inevitable outcomes of conflict. They represent a systematic assault on childbirth.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where countless of pregnant women are trapped.
Women have been killed, denied medical attention, or forced to give birth in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 taken hostage, 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 areas of fighting, information is scarce.
Last year, findings indicated that one in two mothers who died during pregnancy or childbirth were in a conflict area. This underscores a devastating pattern.
In addition to the loss of life, these attacks are destroying hospitals and wards, creating a grave danger to societal repopulation and recovery.
Conditions within Gaza
In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as part of the basis for accusations of genocidal acts.
Following truces, doctors report that women and children are still perishing from medical shortages, owing to desperate lacks of medicine and equipment. Accounts describe women giving birth in rubble because hospitals could not be reached.
“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.
Ukraine's Ordeal
Since early 2022, at least 80 maternity and neonatal facilities 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.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“The reality is, every facility can be under attack now,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris could impact a hospital.”
A Culture of Impunity
For the more than 676 million women living within range of fighting, there are scarce guarantees and rare trials for atrocities for those targeting maternity care.
This absence of consequences has led to a “atmosphere of lawlessness,” explains a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, can be understood as acts of genocide by destroying a group's future.”
Other Conflict Zones
In El Fasher, the area was isolated from humanitarian aid long before the hospital attack, with malnutrition increasing drastically, especially among children and pregnant women.
In the Democratic Republic of the Congo, information is restricted due to a inability to report 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 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 without skilled assistance.
“The deliberate attack on maternity wards speaks to a wider and more disturbing trend: the use of violence against hospitals as a weapon to spread fear and to break societal cohesion,” says a legal researcher.
“Hospitals are not completely safe 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.”
