Childbirth Under Attack: How Women and Babies Became Casualties in Worldwide Wars.

A group of thirty mothers had taken refuge in a childbirth facility in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, while others were in the midst of labor.

Working that 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. Those who could run, fled.”

This horrifying event stands as a particularly egregious examples in the protracted internal conflict tearing the African nation apart. Militiamen stormed the facility, reportedly killing more than 460 innocent people inside.

Rights organizations have labeled it “an act of unspeakable brutality,” and a stark illustration of the deteriorating protection for civilians caught in conflict zones in several nations at war.

A Record of Violence Against Maternal Care

Although world powers are signatories to the Geneva conventions, which obligate them to protect civilians, the past year has witnessed an unprecedented spike of violence targeting health services. Expectant mothers are exceptionally vulnerable due to their need for locally available medical care.

An investigation of records show an unprecedented scale of attacks: nearly 300 violent acts against places and people associated with childbirth over the last three years, including at least 119 direct strikes on hospitals and delivery wards.

“These are not inevitable outcomes of conflict. They constitute a systematic assault on childbirth.”

The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where hundreds of thousands of expectant mothers are stranded.

Deaths have occurred, blocked from reaching help, or forced to give birth in deplorable situations. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been slain, 15 taken hostage, and 101 arrested—sometimes during medical procedures.

A Worldwide Emergency in Maternal Health

Statistics are thought to be a significant underestimate, as they are limited to incidents reported in news outlets. In many conflict zones, reporting is limited.

Last year, findings indicated that half of all women who died during pregnancy or childbirth lived amidst hostilities. This underscores a horrifying trend.

In addition to the loss of life, these attacks are obliterating critical infrastructure for mothers and babies, posing a long-term threat to demographic stability.

Conditions within Gaza

In Gaza, the devastating effect on the right to maternal care 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 a lack of proper treatment, owing to desperate lacks of medicine and equipment. Agencies have reported women having children by the roadside because hospitals were out of reach.

“Our facility has endured missile strikes hitting 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 hospitals for mothers and babies have been damaged or destroyed in Ukraine. Accounts from embattled medical centers describe births taking place in basements and extreme psychological pressure leading to maternal health issues.

“The attacks on us are intentional,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected 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 could impact a hospital.”

A Culture of Impunity

For the hundreds of millions of women living within range of fighting, there are scarce guarantees and a stark lack of legal accountability for those targeting maternity care.

This void of justice has led to a “atmosphere of lawlessness,” argues a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by preventing births.”

Additional Hotspots

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 scarce because of a inability to report from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, causing fatalities among patients and staff.

In Myanmar, clinics have been attacked and dozens of midwives and patients have suffered violence 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 destroys healthcare networks. 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 speaks to a broader and more sinister pattern: the use of attacks on medical facilities as a tool for terror and to destroy community bonds,” observes a legal researcher.

“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities may forfeit their immunity if used for acts deemed ‘militarily advantageous’, which has increasingly been used as a justification.”