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Dozens of women were seeking shelter in a maternity hospital in El Fasher, Sudan, as the slaughter began. 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, managed to survive the ordeal. “There were cries of women and children,” he explains. “A massacre was taking place inside the hospital. We who were able to escape, did so.”

This horrifying event stands as among the worst examples in the two-year civil war tearing the African nation apart. Armed soldiers raided the hospital, reportedly killing more than 460 innocent people inside.

Rights organizations have labeled it “a crime beyond words,” and a prime example 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 agreed to the Geneva conventions, which commit them to defending civilians, the past year has seen a record number of assaults against medical infrastructure. Expectant mothers are exceptionally vulnerable due to their dependence on locally available medical care.

Data analysis and investigations 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 targeted attacks against hospitals and delivery wards.

“These incidents do not represent standard wartime hazards. They represent a deliberate strategy of violence against reproduction.”

The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where countless of pregnant women are trapped.

Mothers have lost their lives, denied medical attention, or forced to give birth in dangerous and unsanitary conditions. The data also indicates that at least 68 maternal health workers have been killed, 15 kidnapped, and 101 arrested—sometimes while assisting births.

The Global Crisis in Maternal Health

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

Last year, findings indicated that half of all women who perished while pregnant or giving birth were in a conflict area. This underscores a devastating pattern.

Beyond killing women and staff, these attacks are destroying critical infrastructure for mothers and babies, creating a grave danger to demographic stability.

The Situation in Gaza

In Gaza, the ruinous consequences on the right to maternal care has been cited by a UN commission as one reason behind declaring certain actions a genocide.

Despite periods of calm, doctors report that women and children continue to die from inadequate care, owing to critical shortages of medicine and equipment. Agencies have reported women giving birth in rubble because hospitals were inaccessible.

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

The Crisis in Ukraine

Since early 2022, at least 80 maternity and neonatal facilities have been damaged or destroyed in Ukraine. Accounts from embattled medical centers describe births forced underground and skyrocketing stress leading to maternal health issues.

“We are being singled out,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. The government has disputed deliberately targeting civilians.

“The reality is, every facility is now a potential target,” comments a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris can strike a hospital.”

Accountability Evaporates

For the over half a billion females living within range of fighting, there are minimal protections and a stark lack of legal accountability for those attacking childbirth services.

This lack of accountability has created a “environment where anything goes,” says a human rights lawyer. “Assaults against maternal services, like coerced birth or involuntary sterilization, may constitute acts of genocide by destroying a group's future.”

Additional Hotspots

In El Fasher, the area lacked access to 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 scarce because of a communication blackout from rebel-held areas. Nevertheless, shelling in Goma damaged a maternity hospital, killing mothers, babies, and nurses.

In Myanmar, clinics have been attacked 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 avoidable with standard medicine, 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 wider and more disturbing trend: the use of violence against hospitals as a means of intimidation and to break societal cohesion,” notes 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 ‘harmful to the enemy’, which has now become a standard defence.”