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Dozens of women had taken refuge in a childbirth facility in El Fasher, Sudan, as the slaughter began. Several had recently given birth, while others were experiencing childbirth.

Working that night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, became one of the few known survivors. “The sounds of screaming reached me of women and children,” he states. “They executed everybody inside the hospital. We who were able to escape, did so.”

This horrifying event stands as one of the most shocking examples in the ongoing war tearing the African nation apart. Militiamen raided the hospital, leaving dead more than 460 patients and their companions.

Rights organizations have called it “a crime beyond words,” and a stark illustration of the vanishing safeguards for civilians caught in conflict zones in several nations at war.

A Record of Violence Against Maternal Care

Despite every significant nation are signatories to the Geneva conventions, which commit them to defending civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Mothers in labor are exceptionally vulnerable due to their need for locally available medical care.

Data analysis and investigations reveal an unprecedented scale of attacks: nearly 300 attacks on and disruptions to maternity care facilities, staff, and pregnant women over the last three years, including at least 119 direct strikes on hospitals and delivery wards.

“These are not natural consequences of war. They represent a systematic assault on childbirth.”

The majority of these attacks have taken place in regions embroiled in intense conflict, where hundreds of thousands of expectant mothers are stranded.

Mothers have lost their lives, denied medical attention, or made to have their babies in deplorable situations. The data also indicates that at least 68 maternal health workers have been murdered, 15 abducted, and 101 arrested—sometimes in the act of delivering babies.

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 war-torn areas, communications are sparse.

Last year, analysis showed that one in two mothers who lost their lives in maternal circumstances lived amidst hostilities. This underscores a devastating pattern.

Apart from fatalities, these attacks are wrecking hospitals and wards, posing a long-term threat to community survival.

The Situation in Gaza

In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as part of the basis for genocide allegations.

Despite periods of calm, doctors report that women and children succumb from a lack of proper treatment, owing to critical shortages of medicine and equipment. UN officials have relayed women having children by the roadside because hospitals were inaccessible.

“Our facility has endured missile strikes fired at 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.

Ukraine's Ordeal

Since early 2022, at least 80 childbirth centers have been damaged or destroyed in Ukraine. Accounts from embattled medical centers describe births taking place in basements and skyrocketing stress leading to maternal health issues.

“Russia is targeting us deliberately,” says 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 is now a potential target,” states a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris could impact a hospital.”

A Culture of Impunity

For the more than 676 million women living near active conflicts, there are scarce guarantees and a stark lack of legal accountability for those targeting maternity care.

This void of justice has led to a “culture of impunity,” says a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, may constitute 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 limited by a communication blackout from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, causing fatalities among patients and staff.

In Myanmar, medical facilities have been bombed 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

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 without skilled assistance.

“The deliberate attack on maternity wards indicates a larger and alarming strategy: the use of attacks on medical facilities as a means of intimidation and to destroy community bonds,” notes a legal researcher.

“Hospitals are not completely safe 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.”