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Thirty women had taken refuge in a childbirth facility in El Fasher, Sudan, as the slaughter began. Several had recently given birth, while others were actively in labor.

Present at the hospital after dark, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “The sounds of screaming reached me of women and children,” he recounts. “They were killing everyone inside the hospital. Those who could run, fled.”

This brutal attack stands as a particularly egregious examples in the protracted internal conflict tearing the North African nation apart. Combatants stormed the facility, leaving dead more than 460 individuals receiving care and their families.

Rights organizations have called it “a crime beyond words,” and a stark illustration of the vanishing safeguards for civilians caught in conflict zones in several nations at war.

An Unprecedented Assault Against Maternal Care

Despite every significant nation have signed the Geneva conventions, which commit them to defending civilians, the past year has witnessed an unprecedented spike of attacks on healthcare systems. Expectant mothers are particularly at risk due to their need for locally available medical care.

An investigation of records uncover 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 direct strikes on hospitals and delivery wards.

“This is not 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 hundreds of thousands of women bearing children are confined.

Women have been killed, blocked from reaching help, or compelled to deliver in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 taken hostage, and 101 arrested—sometimes in the act of delivering babies.

A Worldwide Emergency for Mothers and Newborns

The numbers are probably a substantial underreporting, as they capture solely incidents documented publicly. In many conflict zones, reporting is limited.

Last year, it was reported that half of all women who lost their lives in maternal circumstances lived amidst hostilities. This underscores a horrifying trend.

Apart from fatalities, these attacks are wrecking hospitals and wards, posing a long-term threat to demographic stability.

Conditions within Gaza

In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as part of the basis for declaring certain actions a genocide.

Following truces, doctors report that women and children continue to die from a lack of proper treatment, owing to desperate lacks of medicine and equipment. Agencies have reported women delivering babies amidst ruins because hospitals were out of reach.

“We’ve had rockets targeting the wards, operating rooms, and maternity wards,” says the head of a major hospital’s gynecology department. A military spokesperson has contested deliberately targeting maternity care or aiming to influence birthrates.

Ukraine's Ordeal

Since early 2022, at least 80 childbirth centers have been attacked and rendered unusable in Ukraine. Reports from frontline hospitals describe births forced underground and extreme psychological pressure leading to maternal health issues.

“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 truth of the matter is, every facility can be under attack now,” states a medical director in Sumy. “If a drone is destroyed, the falling debris can strike a hospital.”

A Culture of Impunity

For the more than 676 million women living within range of fighting, there are scarce guarantees and rare trials for atrocities for those targeting maternity care.

This absence of consequences has led to a “culture of impunity,” argues a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, 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 rising sharply, especially among children and pregnant women.

In the Democratic Republic of the Congo, information is limited by a lack of access from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, resulting in tragic loss of life.

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

A large proportion of mother deaths are preventable with routine care, but war collapses medical infrastructure. 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 broader and more sinister pattern: the use of attacks on medical facilities as a weapon to spread fear and to destroy community bonds,” says a legal researcher.

“There is no absolute protection for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘prejudicial to the opposing side’, which has often been cited as an excuse.”