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Thirty women were huddled for safety in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. Among them were new mothers, while others were experiencing childbirth.

On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “The sounds of screaming reached me of women and children,” he recounts. “They were killing everyone inside the hospital. Those who could run, fled.”

This horrifying event stands as one of the most shocking examples in the two-year civil war tearing the North African nation apart. Militiamen stormed the facility, leaving dead more than 460 individuals receiving care and their families.

Rights organizations have labeled it “a crime beyond words,” and a clear case of the vanishing safeguards for civilians living amidst warfare in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.

An Unprecedented Assault On Childbirth Services

While all major powers have signed the Geneva conventions, which require them to safeguard civilians, the past year has seen a record number of violence targeting health services. Mothers in labor are highly exposed due to their reliance on locally available medical care.

Data analysis and investigations uncover an shocking trend: nearly 300 incidents targeting or hindering places and people associated with childbirth over the last three years, including at least 119 direct strikes on hospitals and delivery wards.

“These incidents do not represent natural consequences of war. They constitute a deliberate strategy of violence against reproduction.”

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

Deaths have occurred, prevented from accessing care, or made to have their babies in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 abducted, and 101 arrested—sometimes during medical procedures.

A Worldwide Emergency in Maternal Health

Statistics are thought to be a significant underestimate, as they capture solely incidents documented publicly. In many war-torn areas, reporting is limited.

Last year, findings indicated that 50% of women who lost their lives in maternal circumstances were in a conflict area. This underscores a catastrophic reality.

In addition to the loss of life, these attacks are obliterating maternal and neonatal care facilities, posing a long-term threat to community survival.

The Situation in Gaza

In Gaza, the ruinous consequences on reproductive health rights has been cited by a UN commission as a factor in accusations of genocidal acts.

Following truces, 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 having children by the roadside because hospitals were inaccessible.

“Direct shelling targeting 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 seeking to affect birthrates.

The Crisis in Ukraine

Since early 2022, at least 80 childbirth centers have been struck and ruined in Ukraine. Journalism from conflict zones describe births forced underground and skyrocketing stress leading to birth complications.

“Russia is targeting us deliberately,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.

“The reality is, every facility faces the threat of assault,” notes 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 over half a billion females living close to deadly warfare, there are few safeguards and a stark lack of legal accountability for those assaulting reproductive health.

This void of justice has created a “atmosphere of lawlessness,” explains a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, may constitute acts of genocide by preventing births.”

Other Conflict Zones

In El Fasher, the area was isolated from 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 scarce because of a inability to report from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, killing mothers, babies, and nurses.

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

The majority of childbirth fatalities are averted with basic healthcare, but war collapses medical infrastructure. Rights groups note that fear is now driving women away from facilities once considered safe, pushing them toward risky home births lacking professional help.

“When childbirth centers become intentional targets speaks to a broader and more sinister pattern: 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 ‘harmful to the enemy’, which has often been cited as an excuse.”