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Thirty women were seeking shelter in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. 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. “There were cries of women and children,” he states. “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 African nation apart. Armed soldiers raided the hospital, leaving dead more than 460 innocent people inside.

Rights organizations have described it as “an act of unspeakable brutality,” and a clear case of the collapse in safety for civilians trapped in war-torn areas in multiple global hotspots.

An Unprecedented Assault Against Maternal Care

Despite every significant nation have signed the Geneva conventions, which require them to safeguard civilians, the past year has witnessed an unprecedented spike of attacks on healthcare systems. Mothers in labor are particularly at risk due to their reliance on locally available medical care.

An investigation of records show 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.

“This is not natural consequences of war. They represent a deliberate strategy of violence against reproduction.”

The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where a vast number of expectant mothers are stranded.

Mothers have lost their lives, prevented from accessing care, or forced to give birth in deplorable situations. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been killed, 15 abducted, and 101 detained—sometimes in the act of delivering babies.

The Global Crisis in Maternal Health

The numbers are probably a significant underestimate, as they are limited to incidents reported in news outlets. In many war-torn areas, communications are sparse.

Last year, analysis showed that 50% of women who lost their lives in maternal circumstances resided in a war zone. This underscores a horrifying trend.

Beyond killing women and staff, these attacks are destroying maternal and neonatal care facilities, creating a grave danger to community survival.

The Situation in 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 accusations of genocidal acts.

Despite periods of calm, doctors report that women and children continue to die from medical shortages, owing to critical shortages of medicine and equipment. Accounts describe women giving birth in rubble because hospitals could not be reached.

“Our facility has endured missile strikes fired at 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 seeking to affect birthrates.

The Crisis in Ukraine

Since early 2022, at least 80 childbirth centers have been struck and ruined in Ukraine. Reports from frontline hospitals describe births taking place in basements and extreme psychological pressure leading to birth complications.

“The attacks on us are intentional,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.

“The reality is, every facility is now a potential target,” notes a medical director in Sumy. “Even if air defence intercepts a drone, the falling debris can strike a hospital.”

Accountability Evaporates

For the hundreds of millions of women living close to deadly warfare, there are few safeguards and a stark lack of legal accountability for those attacking childbirth services.

This absence of consequences has led to a “environment where anything goes,” argues a human rights lawyer. “Attacks on reproductive healthcare, like forced pregnancy or forced sterilisation, can be understood as 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 spiking dangerously, especially among children and pregnant women.

In the Democratic Republic of the Congo, information is restricted due to a lack of access from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, 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 Collapse of Safe Childbirth

The majority of childbirth fatalities are preventable with routine care, but war destroys healthcare networks. Rights groups note that anxiety is forcing women away from facilities once considered safe, leading them to risky home births lacking professional help.

“The deliberate attack on maternity wards indicates a wider and more disturbing trend: the use of attacks on medical facilities as a means of intimidation and to tear apart the social fabric,” notes 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 now become a standard defence.”