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.
Present at the hospital after dark, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “There were cries of women and children,” he explains. “They were killing everyone inside the hospital. Those who could run, fled.”
This brutal attack stands as a particularly egregious examples in the two-year civil war tearing the African nation apart. Combatants raided the hospital, reportedly killing more than 460 innocent people inside.
Rights organizations have described it as “an unspeakable atrocity,” and a clear case of the deteriorating protection for civilians trapped in war-torn areas in multiple global hotspots.
A Record of Violence On Childbirth Services
While all major powers have signed the international laws of war, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Women undergoing childbirth are exceptionally vulnerable due to their dependence on locally available medical care.
Data analysis and investigations reveal an shocking trend: 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 standard wartime hazards. They form a deliberate strategy of violence against reproduction.”
The majority of these attacks have taken place in Ukraine, Gaza, and Sudan, where hundreds of thousands of women bearing children are confined.
Mothers have lost their lives, denied medical attention, or compelled to deliver in deplorable situations. The data also indicates that at least 68 maternal health workers have been killed, 15 abducted, and 101 detained—sometimes in the act of delivering babies.
A Worldwide Emergency in Maternal Health
Statistics are thought to be a significant underestimate, as they only include incidents covered by the media. In many war-torn areas, reporting is limited.
Last year, analysis showed that 50% of women who died during pregnancy or childbirth resided in a war zone. This underscores a catastrophic reality.
Beyond killing women and staff, these attacks are obliterating hospitals and wards, jeopardizing the future to societal repopulation and recovery.
The Situation in Gaza
In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as a factor in declaring certain actions a genocide.
Even after ceasefires, doctors report that women and children succumb from a lack of proper treatment, owing to desperate lacks of medicine and equipment. UN officials have relayed women giving birth in rubble because hospitals could not be reached.
“Our facility has endured missile strikes targeting 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 seeking to affect birthrates.
The Crisis in Ukraine
Since early 2022, at least 80 hospitals for mothers and babies have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births forced underground and skyrocketing stress leading to birth complications.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected 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 hundreds of millions of women living within range of fighting, there are scarce guarantees and rare trials for atrocities for those attacking childbirth services.
This void of justice has fostered a “atmosphere of lawlessness,” explains a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, are potentially acts of genocide by destroying a group's future.”
Other Conflict Zones
In El Fasher, the area lacked access to 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 restricted due to 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
A large proportion of mother deaths are preventable with routine care, but war shatters health systems. Rights groups note that terror is compelling women away from facilities once considered safe, pushing them toward risky home births without skilled assistance.
“The deliberate attack on maternity wards indicates a broader and more sinister pattern: the use of attacks on medical facilities as a tool for terror and to tear apart the social fabric,” observes a legal researcher.
“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has increasingly been used as a justification.”
