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A group of thirty mothers had taken refuge in a childbirth facility in El Fasher, Sudan, as the slaughter began. Some had just delivered their newborns, while others were experiencing childbirth.

Working that night, a 28-year-old lab technician, a technician named Abdo-Rabo Ahmed, lived to tell the tale. “I heard the screams of women and children,” he states. “A massacre was taking place inside the hospital. Those who could run, fled.”

This appalling incident stands as one of the most shocking examples in the two-year civil war tearing the North African nation apart. Armed soldiers forced their way into the building, allegedly slaughtering more than 460 innocent people inside.

Rights organizations have labeled it “an act of unspeakable brutality,” and a clear case of the collapse in safety for civilians living amidst warfare in Ukraine, Gaza, Myanmar, the Democratic Republic of the Congo, and Sudan.

An Unprecedented Assault On Childbirth Services

Despite every significant nation are signatories to the international laws of war, which commit them to defending civilians, the past year has experienced a historic high of assaults against medical infrastructure. Mothers in labor are exceptionally vulnerable due to their reliance on locally available medical care.

Data analysis and investigations show an shocking trend: nearly 300 incidents targeting or hindering places and people associated with childbirth over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.

“This is not natural consequences of war. They constitute a systematic assault on childbirth.”

The majority of these assaults have occurred in Ukraine, Gaza, and Sudan, where countless of expectant mothers are stranded.

Mothers have lost their lives, prevented from accessing care, or compelled to deliver in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been killed, 15 abducted, and 101 detained—sometimes while assisting births.

The Global Crisis for Mothers and Newborns

The numbers are probably a grave undercount, as they only include incidents documented publicly. In many conflict zones, communications are sparse.

Last year, analysis showed that one in two mothers who lost their lives in maternal circumstances resided in a war zone. This underscores a devastating pattern.

In addition to the loss of life, these attacks are wrecking hospitals and wards, creating a grave danger to societal repopulation and recovery.

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 declaring certain actions a genocide.

Following truces, doctors report that women and children succumb from medical shortages, owing to desperate lacks of medicine and equipment. UN officials have relayed women having children by the roadside because hospitals were out of reach.

“We’ve had rockets hitting the wards, operating rooms, and maternity wards,” explains 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 childbirth centers have been attacked and rendered unusable in Ukraine. Journalism from conflict zones describe births forced underground and skyrocketing stress leading to problems during delivery.

“The attacks on us are intentional,” asserts the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.

“The truth of the matter is, every facility faces the threat of assault,” states a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”

A Culture of Impunity

For the over half a billion females living within range of fighting, there are scarce guarantees and a stark lack of legal accountability for those targeting maternity care.

This absence of consequences has fostered a “atmosphere of lawlessness,” says a human rights lawyer. “Assaults against maternal services, like forced pregnancy or forced sterilisation, can be understood as acts of genocide by destroying a group's future.”

Other Conflict Zones

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 restricted due to a lack of access from rebel-held areas. Nevertheless, shelling in Goma struck a baby care unit, 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 Collapse of Safe Childbirth

Most maternal deaths are averted with basic healthcare, but war collapses medical infrastructure. Rights groups note that fear is now driving women away from facilities once considered safe, resulting in risky home births devoid of emergency care.

“When childbirth centers become intentional targets speaks to a larger and alarming strategy: the use of attacks on medical facilities as a means of intimidation and to break societal cohesion,” observes 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.”