The Targeting of Childbirth: How Women and Babies Became Casualties in Worldwide Wars.

Dozens of women 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 in the midst of labor.

Present at the hospital after dark, a 28-year-old lab technician, Abdo-Rabo Ahmed, became one of the few known survivors. “The sounds of screaming reached me of women and children,” he explains. “A massacre was taking place inside the hospital. Survival meant running for your life.”

This brutal attack stands as a particularly egregious examples in the two-year civil war tearing the North African nation apart. Combatants stormed the facility, allegedly slaughtering more than 460 patients and their companions.

Rights organizations have called it “an act of unspeakable brutality,” 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

While all major powers have signed the Geneva conventions, which commit them to defending civilians, the past year has experienced a historic high of violence targeting health services. Women undergoing childbirth are highly exposed due to their need for locally available medical care.

Research and compiled data uncover an alarming level of violence: nearly 300 violent acts against maternity care facilities, staff, and pregnant women over the last three years, including at least 119 targeted attacks against hospitals and delivery wards.

“This is not natural consequences of war. They represent a pattern of reproductive violence.”

The majority of these attacks have taken place in regions embroiled in intense conflict, where a vast number of women bearing children are confined.

Women have been killed, denied medical attention, or made to have their babies in perilous and unsafe environments. The data also indicates that at least 68 maternal health workers have been slain, 15 abducted, and 101 taken into custody—sometimes in the act of delivering babies.

The Global Crisis for Mothers and Newborns

The numbers are probably a grave undercount, as they capture solely incidents documented publicly. In many war-torn areas, information is scarce.

Last year, analysis showed that half of all women who lost their lives in maternal circumstances were in a conflict area. This underscores a catastrophic reality.

In addition to the loss of life, these attacks are wrecking hospitals and wards, jeopardizing the future to societal repopulation and recovery.

Conditions within Gaza

In Gaza, the catastrophic impact on reproductive health rights has been cited by a UN commission as part of the basis for declaring certain actions a genocide.

Even after ceasefires, doctors report that women and children continue to die from inadequate care, owing to severe deficits of medicine and equipment. Agencies have reported women having children by the roadside because hospitals were out of reach.

“Direct shelling hitting the wards, operating rooms, and maternity wards,” states the head of a major hospital’s gynecology department. A military spokesperson has denied deliberately targeting maternity care or trying to alter birthrates.

The Crisis in Ukraine

Since early 2022, at least 80 childbirth centers have been attacked and rendered unusable in Ukraine. Accounts from embattled medical centers describe births forced underground and skyrocketing stress leading to birth complications.

“Russia is targeting us deliberately,” claims 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,” comments 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 within range of fighting, there are minimal protections and rare trials for atrocities for those targeting maternity care.

This void of justice has led to a “culture of impunity,” explains a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, may constitute acts of genocide by hindering reproduction.”

Other Conflict Zones

In El Fasher, the area had been cut off from 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 scarce because of a lack of access from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, causing fatalities among patients and staff.

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

Most maternal deaths are preventable with routine care, but war shatters health systems. Rights groups note that fear is now driving women away from facilities once considered safe, leading them to risky home births lacking professional help.

“When childbirth centers become intentional targets points toward a broader and more sinister pattern: the use of violence against hospitals as a tool for terror and to destroy community bonds,” says 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 ‘prejudicial to the opposing side’, which has now become a standard defence.”