A group of thirty mothers had taken refuge in a maternity hospital in El Fasher, Sudan, when the massacre started. Several had recently given birth, while others were actively in labor.
On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “There were cries of women and children,” he recounts. “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 African nation apart. Militiamen raided the hospital, leaving dead more than 460 individuals receiving care and their families.
Rights organizations have labeled it “an unspeakable atrocity,” and a prime example of the deteriorating protection for civilians trapped in war-torn areas in multiple global hotspots.
A Record of Violence Against Maternal Care
While all major powers have agreed to the international laws of war, which require them to safeguard civilians, the past year has seen a record number of attacks on healthcare systems. Mothers in labor are highly exposed due to their dependence on locally available medical care.
Research and compiled data show an shocking trend: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.
“These are not natural consequences of war. They represent a pattern of reproductive violence.”
The majority of these attacks have taken place in regions embroiled in intense conflict, where countless of women bearing children are confined.
Women have been killed, denied medical attention, or forced to give birth in dangerous and unsanitary conditions. The data also indicates that at least 68 maternal health workers have been killed, 15 kidnapped, and 101 detained—sometimes while assisting births.
The Global Crisis for Mothers and Newborns
Statistics are thought to be a significant underestimate, as they capture solely incidents covered by the media. In many areas of fighting, information is scarce.
Last year, it was reported that one in two mothers who died during pregnancy or childbirth were in a conflict area. This underscores a horrifying trend.
Apart from fatalities, these attacks are obliterating hospitals and wards, posing a long-term threat to societal repopulation and recovery.
The Situation in Gaza
In Gaza, the ruinous consequences on reproductive health rights has been cited by a UN commission as a factor in genocide allegations.
Despite periods of calm, doctors report that women and children continue to die from inadequate care, owing to desperate lacks of medicine and equipment. Agencies have reported women having children by the roadside because hospitals were inaccessible.
“Direct shelling hitting 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 childbirth centers have been attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births taking place in basements and extreme psychological pressure leading to birth complications.
“We are being singled out,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.
“In fact, every facility faces the threat of assault,” comments a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris may hit a hospital.”
A Culture of Impunity
For the hundreds of millions of women living close to deadly warfare, there are few safeguards and a stark lack of legal accountability for those targeting maternity care.
This absence of consequences has created a “environment where anything goes,” says a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, can be understood as acts of genocide by hindering reproduction.”
Other Conflict Zones
In El Fasher, the area was isolated from 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 restricted due to a inability to report from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, killing mothers, babies, and nurses.
In Myanmar, medical facilities have been bombed and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.
The End of Safe Deliveries
The majority of childbirth fatalities are preventable with routine care, 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.
“When childbirth centers become intentional targets speaks to a wider and more disturbing trend: 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 can lose their protected status if used for acts deemed ‘prejudicial to the opposing side’, which has often been cited as an excuse.”
