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A group of thirty mothers had taken refuge 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.

Present at the hospital after dark, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “I heard the screams of women and children,” he explains. “They executed everybody inside the hospital. We who were able to escape, did so.”

This appalling incident stands as one of the most shocking examples in the ongoing war tearing the North African nation apart. Combatants stormed the facility, allegedly slaughtering more than 460 individuals receiving care and their families.

Rights organizations have labeled it “an act of unspeakable brutality,” and a stark illustration of the deteriorating protection for civilians living amidst warfare in multiple global hotspots.

A Record of Violence Against Maternal Care

Although world powers have agreed to the Geneva conventions, which obligate them to protect civilians, the past year has experienced a historic high of violence targeting health services. Women undergoing childbirth are highly exposed due to their reliance on locally available medical care.

Research and compiled data reveal an shocking trend: nearly 300 attacks on and disruptions to 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 deliberate strategy of violence against reproduction.”

The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where countless of women bearing children are confined.

Women have been killed, blocked from reaching help, or made to have their babies in dangerous and unsanitary conditions. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 taken hostage, and 101 detained—sometimes during medical procedures.

A Worldwide Emergency in Maternal Health

Statistics are thought to be a substantial underreporting, as they are limited to incidents covered by the media. In many conflict zones, communications are sparse.

Last year, findings indicated that one in two mothers who died during pregnancy or childbirth were in a conflict area. This underscores a horrifying trend.

Apart from fatalities, these attacks are destroying critical infrastructure for mothers and babies, jeopardizing the future to demographic stability.

Conditions within Gaza

In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as part of the basis for genocide allegations.

Following truces, doctors report that women and children are still perishing from medical shortages, owing to severe deficits of medicine and equipment. Accounts describe women giving birth in rubble because hospitals could not be reached.

“Direct shelling 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 trying to alter 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 maternal health issues.

“The attacks on us are intentional,” claims 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,” states a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris may hit a hospital.”

A Culture of Impunity

For the more than 676 million women living within range of fighting, there are minimal protections and rare trials for atrocities for those attacking childbirth services.

This absence of consequences has fostered a “atmosphere of lawlessness,” explains a human rights lawyer. “Attacks on reproductive healthcare, like coerced birth or involuntary sterilization, can be understood as acts of genocide by hindering reproduction.”

Other Conflict Zones

In El Fasher, the area lacked access to humanitarian aid long before the hospital attack, with malnutrition increasing drastically, 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 struck a baby care unit, resulting in tragic loss of life.

In Myanmar, clinics have been attacked 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, resulting in risky home births lacking professional help.

“When childbirth centers become intentional targets points toward a larger and alarming strategy: the use of attacks on medical facilities as a means of intimidation and to tear apart the social fabric,” observes a legal researcher.

“Safeguards are not guaranteed for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘militarily advantageous’, which has increasingly been used as a justification.”