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Thirty women were huddled for safety in a maternity hospital in El Fasher, Sudan, at the onset of the horrific violence. Some had just delivered their newborns, while others were actively in labor.

On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, managed to survive the ordeal. “I heard the screams of women and children,” he states. “They executed everybody inside the hospital. Those who could run, fled.”

This appalling incident stands as among the worst examples in the protracted internal conflict tearing the North African nation apart. Armed soldiers stormed the facility, allegedly slaughtering more than 460 individuals receiving care and their families.

Rights organizations have described it as “an act of unspeakable brutality,” and a clear case of the vanishing safeguards for civilians caught in conflict zones in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.

A Record of Violence On Childbirth Services

Despite every significant nation have agreed to the Geneva conventions, which obligate them to protect civilians, the past year has seen a record number of attacks on healthcare systems. Mothers in labor are particularly at risk due to their need for locally available medical care.

Research and compiled data show an alarming level of violence: nearly 300 incidents targeting or hindering maternity care facilities, staff, and pregnant women over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.

“These are not inevitable outcomes of conflict. They represent a deliberate strategy of violence against reproduction.”

The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where countless of pregnant women are trapped.

Mothers have lost their lives, prevented from accessing care, or made to have their babies in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 kidnapped, and 101 detained—sometimes during medical procedures.

A Worldwide Emergency for Mothers and Newborns

These figures likely represent a substantial underreporting, as they are limited to incidents documented publicly. In many conflict zones, reporting is limited.

Last year, findings indicated that half of all women who lost their lives in maternal circumstances resided in a war zone. This underscores a horrifying trend.

Apart from fatalities, these attacks are obliterating maternal and neonatal care facilities, jeopardizing the future to demographic stability.

The Situation in Gaza

In Gaza, the devastating effect on reproductive health rights has been cited by a UN commission as one reason behind genocide allegations.

Despite periods of calm, doctors report that women and children continue to die from medical shortages, owing to severe deficits of medicine and equipment. Agencies have reported women having children by the roadside because hospitals were inaccessible.

“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 trying to alter birthrates.

The Crisis in Ukraine

Since early 2022, at least 80 childbirth centers have been damaged or destroyed in Ukraine. Journalism from conflict zones describe births taking place in basements and skyrocketing stress leading to maternal health issues.

“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,” notes a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”

Accountability Evaporates

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

This absence of consequences has created a “atmosphere of lawlessness,” argues a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, are potentially acts of genocide by hindering reproduction.”

Additional Hotspots

In El Fasher, the area had been cut off 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 limited by a inability to report from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, resulting in tragic loss of life.

In Myanmar, hospitals have come under fire 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

Most maternal deaths are avoidable with standard medicine, but war collapses medical infrastructure. Rights groups note that anxiety is forcing women away from facilities once considered safe, leading them to risky home births without skilled assistance.

“The deliberate attack on maternity wards points toward a broader and more sinister pattern: the use of attacks on medical facilities as a tool for terror and to break societal cohesion,” 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 ‘harmful to the enemy’, which has increasingly been used as a justification.”