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A group of thirty mothers were huddled for safety in a maternity hospital in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, while others were actively in labor.

On duty during that fateful night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, managed to survive the ordeal. “There were cries of women and children,” he states. “They were killing everyone inside the hospital. We who were able to escape, did so.”

This brutal attack stands as a particularly egregious examples in the protracted internal conflict tearing the African nation apart. Armed soldiers stormed the facility, reportedly killing more than 460 individuals receiving care and their families.

Rights organizations have labeled it “a crime beyond words,” and a clear case of the collapse in safety for civilians caught in conflict zones in several nations at war.

An Unprecedented Assault On Childbirth Services

While all major powers have agreed to the international laws of war, which obligate them to protect civilians, the past year has seen a record number of attacks on healthcare systems. Expectant mothers are particularly at risk due to their need for locally available medical care.

Data analysis and investigations show an alarming level of violence: 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 natural consequences of war. They constitute 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 pregnant women are trapped.

Mothers have lost their lives, blocked from reaching help, or made to have their babies in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 kidnapped, and 101 taken into custody—sometimes while assisting births.

A Worldwide Emergency for Mothers and Newborns

Statistics are thought to be a significant underestimate, as they are limited to incidents covered by the media. In many war-torn areas, information is scarce.

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.

Apart from fatalities, these attacks are destroying hospitals and wards, jeopardizing the future to demographic stability.

The Situation in Gaza

In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as a factor in declaring certain actions a genocide.

Despite periods of calm, doctors report that women and children continue to die from medical shortages, owing to desperate lacks of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals could not be reached.

“Our facility has endured missile strikes hitting the wards, operating rooms, and maternity wards,” says 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 maternity and neonatal facilities have been damaged or destroyed in Ukraine. Journalism from conflict zones describe births taking place in basements and extreme psychological pressure leading to problems during delivery.

“Russia is targeting us deliberately,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.

“The reality is, every facility faces the threat of assault,” comments a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”

A Culture of Impunity

For the over half a billion females living close to deadly warfare, there are few safeguards and even fewer war crimes prosecutions for those attacking childbirth services.

This lack of accountability has created a “environment where anything goes,” says a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, 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 spiking dangerously, 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 hit a neonatal ward, causing fatalities among patients and staff.

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

Most maternal deaths are avoidable with standard medicine, but war collapses medical infrastructure. Rights groups note that terror is compelling women away from facilities once considered safe, leading them to risky home births lacking professional help.

“If maternity hospitals are being deliberately targeted indicates a larger and alarming strategy: the use of attacks on medical facilities as a means of intimidation and to break societal cohesion,” notes a legal researcher.

“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities are not inviolable if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”