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Thirty women were seeking shelter in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Several had recently given birth, while others were experiencing childbirth.

Present at the hospital after dark, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “I heard the screams of women and children,” he explains. “A massacre was taking place inside the hospital. Those who could run, fled.”

This brutal attack stands as among the worst examples in the two-year civil war tearing the African nation apart. Combatants forced their way into the building, allegedly slaughtering more than 460 patients and their companions.

Rights organizations have labeled it “an unspeakable atrocity,” and a stark illustration of the collapse in safety for civilians trapped in war-torn areas in multiple global hotspots.

A Record of Violence On Childbirth Services

Despite every significant nation have agreed to the international laws of war, which commit them to defending civilians, the past year has witnessed an unprecedented spike of attacks on healthcare systems. Expectant mothers are exceptionally vulnerable due to their need for locally available medical care.

Research and compiled data show an shocking trend: nearly 300 attacks on and disruptions to 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 natural consequences of war. They form a systematic assault on childbirth.”

The majority of these incidents have happened in regions embroiled in intense conflict, where countless of expectant mothers are stranded.

Deaths have occurred, denied medical attention, or forced to give birth in deplorable situations. The data also indicates that at least 68 midwives, obstetricians, and gynaecologists have been murdered, 15 abducted, and 101 detained—sometimes while assisting births.

A Worldwide Emergency for Mothers and Newborns

Statistics are thought to be a substantial underreporting, as they capture solely incidents covered by the media. In many war-torn areas, communications are sparse.

Last year, analysis showed that half of all women who perished while pregnant or giving birth lived amidst hostilities. This underscores a horrifying trend.

Apart from fatalities, these attacks are destroying critical infrastructure for mothers and babies, creating a grave danger to community survival.

The Situation in Gaza

In Gaza, the devastating effect on the right to maternal care has been cited by a UN commission as one reason behind genocide allegations.

Even after ceasefires, doctors report that women and children are still perishing from medical shortages, owing to severe deficits of medicine and equipment. Accounts describe women delivering babies amidst ruins because hospitals were out of reach.

“We’ve had rockets hitting the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or seeking to affect 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 taking place in basements and skyrocketing stress leading to birth complications.

“We are being singled out,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.

“The truth of the matter is, every facility faces the threat of assault,” comments a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris can strike a hospital.”

Accountability Evaporates

For the over half a billion females living close to deadly warfare, there are minimal protections and a stark lack of legal accountability for those targeting maternity care.

This void of justice has fostered a “environment where anything goes,” argues a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, are potentially 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 spiking dangerously, 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 damaged a maternity hospital, killing mothers, babies, and nurses.

In Myanmar, hospitals have come under fire and dozens of midwives and patients have been arrested, killed, or injured over the past two years of civil war.

The End of Safe Deliveries

A large proportion of mother deaths are preventable with routine care, but war destroys healthcare networks. Rights groups note that terror is compelling women away from facilities once considered safe, pushing them toward risky home births without skilled assistance.

“The deliberate attack on maternity wards indicates a larger and alarming strategy: the use of violence against hospitals 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 are not inviolable if used for acts deemed ‘harmful to the enemy’, which has often been cited as an excuse.”