A group of thirty mothers had taken refuge in a childbirth facility 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. “The sounds of screaming reached me of women and children,” he states. “They were killing everyone inside the hospital. Survival meant running for your life.”
This brutal attack stands as a particularly egregious examples in the ongoing war tearing the North African nation apart. Armed soldiers forced their way into the building, reportedly killing more than 460 patients and their companions.
Rights organizations have labeled it “an unspeakable atrocity,” and a clear case of the collapse in safety for civilians trapped in war-torn areas in several nations at war.
An Unprecedented Assault On Childbirth Services
While all major powers have agreed to the international laws of war, which require them to safeguard civilians, the past year has experienced a historic high of assaults against medical infrastructure. Mothers in labor are particularly at risk due to their reliance on locally available medical care.
An investigation of records show 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 bombardments of hospitals and delivery wards.
“This is not standard wartime hazards. They form a systematic assault on childbirth.”
The majority of these assaults have occurred in regions embroiled in intense conflict, where hundreds of thousands of women bearing children are confined.
Women have been killed, denied medical attention, or made to have their babies in dangerous and unsanitary conditions. The data also indicates that at least 68 maternal health workers have been slain, 15 taken hostage, and 101 detained—sometimes in the act of delivering babies.
A Worldwide Emergency for Mothers and Newborns
Statistics are thought to be a significant underestimate, as they are limited to incidents documented publicly. In many areas of fighting, reporting is limited.
Last year, analysis showed that half of all women who perished while pregnant or giving birth resided in a war zone. This underscores a catastrophic reality.
Apart from fatalities, these attacks are obliterating hospitals and wards, creating a grave danger to demographic stability.
The Situation in Gaza
In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as one reason behind accusations of genocidal acts.
Even after ceasefires, doctors report that women and children continue to die from inadequate care, owing to severe deficits of medicine and equipment. Accounts describe women having children by the roadside because hospitals were inaccessible.
“We’ve had rockets hitting the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or aiming to influence birthrates.
Ukraine's Ordeal
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 skyrocketing stress leading to problems during delivery.
“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.
“In fact, every facility can be under attack now,” states a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris can strike a hospital.”
A Culture of Impunity
For the more than 676 million women living within range of fighting, there are scarce guarantees and even fewer war crimes prosecutions for those attacking childbirth services.
This void of justice has led to a “atmosphere of lawlessness,” says a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by preventing births.”
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 lack of access from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, resulting in tragic loss of life.
In Myanmar, hospitals have come under fire and dozens of midwives and patients have been arrested, killed, or injured 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 fear is now driving women away from facilities once considered safe, pushing them toward risky home births lacking professional help.
“The deliberate attack on maternity wards points toward a broader and more sinister pattern: the use of violence against hospitals as a tool for terror and to tear apart the social fabric,” notes a legal researcher.
“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘harmful to the enemy’, which has now become a standard defence.”