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A group of thirty mothers 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 experiencing childbirth.

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

This horrifying event stands as a particularly egregious examples in the ongoing war tearing the African nation apart. Armed soldiers raided the hospital, leaving dead more than 460 individuals receiving care and their families.

Rights organizations have described it as “a crime beyond words,” and a stark illustration of the collapse in safety for civilians caught in conflict zones in several nations at war.

An Unprecedented Assault On Childbirth Services

Despite every significant nation have signed the international laws of war, which require them to safeguard civilians, the past year has experienced a historic high of assaults against medical infrastructure. Mothers in labor are particularly at risk due to their reliance on locally available medical care.

An investigation of records reveal an alarming level of violence: nearly 300 incidents targeting or hindering places and people associated with childbirth over the last three years, including at least 119 bombardments of hospitals and delivery wards.

“These incidents do not represent natural consequences of war. They form a systematic assault on childbirth.”

The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where hundreds of thousands of women bearing children are confined.

Mothers have lost their lives, denied medical attention, or compelled to deliver in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 abducted, and 101 detained—sometimes during medical procedures.

The Global Crisis for Mothers and Newborns

Statistics are thought to be a significant underestimate, as they are limited to incidents reported in news outlets. In many conflict zones, communications are sparse.

Last year, findings indicated that 50% of women who lost their lives in maternal circumstances lived amidst hostilities. This underscores a catastrophic reality.

In addition to the loss of life, these attacks are obliterating maternal and neonatal care facilities, creating a grave danger to societal repopulation and recovery.

The Situation in Gaza

In Gaza, the catastrophic impact on the right to maternal care has been cited by a UN commission as a factor in accusations of genocidal acts.

Following truces, doctors report that women and children are still perishing 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.

“Our facility has endured missile strikes hitting the wards, operating rooms, and maternity wards,” explains the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or seeking to affect birthrates.

Ukraine's Ordeal

Since early 2022, at least 80 maternity and neonatal facilities have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births forced underground and extreme psychological pressure leading to birth complications.

“The attacks on us are intentional,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Russian authorities have denied deliberately targeting civilians.

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

A Culture of Impunity

For the hundreds of millions of women living near active conflicts, there are minimal protections and rare trials for atrocities for those attacking childbirth services.

This void of justice has led to a “culture of impunity,” says a human rights lawyer. “Violence targeting childbirth, like forced pregnancy or forced sterilisation, are potentially acts of genocide by preventing births.”

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 scarce because of a communication blackout from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, killing mothers, babies, and nurses.

In Myanmar, medical facilities have been bombed and dozens of midwives and patients have suffered violence over the past two years of civil war.

The Collapse of Safe Childbirth

A large proportion of mother deaths are preventable with routine care, but war shatters health systems. Rights groups note that anxiety is forcing women away from facilities once considered safe, pushing them toward risky home births without skilled assistance.

“When childbirth centers become intentional targets indicates a larger and alarming strategy: the use of violence against hospitals as a means of intimidation and to destroy community bonds,” says a legal researcher.

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