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A group of thirty mothers were huddled for safety in a maternity hospital in El Fasher, Sudan, when the massacre started. Some had just delivered their newborns, while others were in the midst of labor.

On duty during that fateful night, a 28-year-old lab technician, Abdo-Rabo Ahmed, lived to tell the tale. “There were cries of women and children,” he states. “A massacre was taking place inside the hospital. Survival meant running for your life.”

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

Rights organizations have labeled it “an unspeakable atrocity,” and a clear case of the vanishing safeguards for civilians trapped in war-torn areas in multiple global hotspots.

A Record of Violence On Childbirth Services

While all major powers are signatories to the Geneva conventions, 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.

Research and compiled data uncover 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.

“These are not natural consequences of war. They represent 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.

Mothers have lost their lives, denied medical attention, or made to have their babies in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 taken hostage, and 101 arrested—sometimes in the act of delivering babies.

The Global Crisis for Mothers and Newborns

Statistics are thought to be a significant underestimate, as they capture solely incidents covered by the media. In many areas of fighting, communications are sparse.

Last year, findings indicated that 50% of women who lost their lives in maternal circumstances were in a conflict area. This underscores a devastating pattern.

Apart from fatalities, these attacks are obliterating maternal and neonatal care facilities, creating a grave danger to community survival.

Conditions within Gaza

In Gaza, the devastating effect 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 continue to die from a lack of proper treatment, 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 targeting 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 aiming to influence birthrates.

Ukraine's Ordeal

Since early 2022, at least 80 childbirth centers have been struck and ruined in Ukraine. Reports from frontline hospitals describe births forced underground and extreme psychological pressure leading to problems during delivery.

“The attacks on us are intentional,” asserts 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 is now a potential target,” states a medical director in Sumy. “If a drone is destroyed, the falling debris could impact a hospital.”

Accountability Evaporates

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

This lack of accountability has created a “environment where anything goes,” says a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, are potentially 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 rising sharply, 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 hit a neonatal ward, killing mothers, babies, and nurses.

In Myanmar, clinics have been attacked 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

The majority of childbirth fatalities are avoidable with standard medicine, but war destroys healthcare networks. Rights groups note that fear is now driving women away from facilities once considered safe, resulting in risky home births lacking professional help.

“When childbirth centers become intentional targets points toward a larger and alarming strategy: the use of attacks on medical facilities as a means of intimidation and to tear apart the social fabric,” 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 ‘prejudicial to the opposing side’, which has often been cited as an excuse.”