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Thirty women had taken refuge in a childbirth facility in El Fasher, Sudan, when the massacre started. Among them were new mothers, while others were in the midst of 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 states. “A massacre was taking place inside the hospital. Survival meant running for your life.”

This brutal attack stands as a particularly egregious examples in the ongoing war tearing the North African nation apart. Armed soldiers forced their way into the building, reportedly killing more than 460 individuals receiving care and their families.

Rights organizations have labeled it “a crime beyond words,” and a stark illustration of the deteriorating protection for civilians living amidst warfare in several nations at war.

An Unprecedented Assault On Childbirth Services

Despite every significant nation have signed 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 uncover an shocking trend: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 bombardments of hospitals and delivery wards.

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

The majority of these incidents have happened in regions embroiled in intense conflict, where countless of women bearing children are confined.

Mothers have lost their lives, denied medical attention, or made to have their babies in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been murdered, 15 taken hostage, and 101 arrested—sometimes while assisting births.

A Worldwide Emergency in Maternal Health

These figures likely represent a grave undercount, as they capture solely incidents reported in news outlets. In many war-torn areas, reporting is limited.

Last year, findings indicated that 50% of women who died during pregnancy or childbirth resided in a war zone. This underscores a horrifying trend.

Apart from fatalities, these attacks are wrecking maternal and neonatal care facilities, creating a grave danger to demographic stability.

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.

Even after ceasefires, doctors report that women and children continue to die 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 out of reach.

“Our facility has endured missile strikes 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 trying to alter birthrates.

The Crisis in Ukraine

Since early 2022, at least 80 maternity and neonatal facilities have been damaged or destroyed in Ukraine. Journalism from conflict zones describe births forced underground 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 can be under attack now,” notes a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris could impact a hospital.”

Accountability Evaporates

For the over half a billion females living close to deadly warfare, there are scarce guarantees and even fewer war crimes prosecutions for those targeting maternity care.

This lack of accountability has created a “environment where anything goes,” explains a human rights lawyer. “Violence targeting childbirth, 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 scarce because of a communication blackout from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, killing mothers, babies, and nurses.

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

Most maternal deaths are averted with basic healthcare, but war destroys healthcare networks. Rights groups note that anxiety is forcing women away from facilities once considered safe, pushing them toward risky home births without skilled assistance.

“If maternity hospitals are being deliberately targeted speaks to a wider and more disturbing trend: the use of violence against hospitals as a means of intimidation and to destroy community bonds,” observes a legal researcher.

“Safeguards are not guaranteed 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.”