Childbirth Under Attack: How Women and Babies Became Targets in Global Conflicts.

Dozens of women were huddled for safety in a childbirth facility in El Fasher, Sudan, at the onset of the horrific violence. Several had recently given birth, while others were experiencing childbirth.

On duty during that fateful night, 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. We who were able to escape, did so.”

This appalling incident stands as one of the most shocking examples in the protracted internal conflict tearing the African nation apart. Militiamen forced their way into the building, leaving dead more than 460 individuals receiving care and their families.

Rights organizations have called it “a crime beyond words,” and a stark illustration of the vanishing safeguards for civilians caught in conflict zones in several nations at war.

A Record of Violence On Childbirth Services

While all major powers have signed the international laws of war, which commit them to defending civilians, the past year has seen a record number of violence targeting health services. Women undergoing childbirth are particularly at risk due to their reliance on locally available medical care.

Research and compiled data reveal an shocking trend: nearly 300 attacks on and disruptions to 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 inevitable outcomes of conflict. They represent a deliberate strategy of violence against reproduction.”

The majority of these incidents have happened in Ukraine, Gaza, and Sudan, where a vast number of expectant mothers are stranded.

Deaths have occurred, prevented from accessing care, or forced to give birth in perilous and unsafe environments. The data also indicates that at least 68 childbirth professionals and specialists have been murdered, 15 abducted, and 101 arrested—sometimes in the act of delivering babies.

A Worldwide Emergency for Mothers and Newborns

The numbers are probably a grave undercount, as they only include incidents documented publicly. In many areas of fighting, information is scarce.

Last year, findings indicated that one in two mothers who died during pregnancy or childbirth resided in a war zone. This underscores a catastrophic reality.

Beyond killing women and staff, these attacks are obliterating critical infrastructure for mothers and babies, jeopardizing the future to societal repopulation and recovery.

The Situation in Gaza

In Gaza, the catastrophic impact on reproductive health rights 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 medical shortages, owing to severe deficits of medicine and equipment. Agencies have reported women delivering babies amidst ruins because hospitals could not be reached.

“We’ve had rockets targeting 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 aiming to influence birthrates.

The Crisis in Ukraine

Since early 2022, at least 80 childbirth centers have been struck and ruined in Ukraine. Accounts from embattled medical centers describe births taking place in basements and skyrocketing stress leading to problems during delivery.

“We are being singled out,” claims the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.

“In fact, every facility can be under attack now,” states a medical director in Sumy. “If a drone is destroyed, the falling debris may hit a hospital.”

Accountability Evaporates

For the over half a billion females living near active conflicts, there are minimal protections and even fewer war crimes prosecutions for those attacking childbirth services.

This lack of accountability has led to a “environment where anything goes,” argues a human rights lawyer. “Violence targeting childbirth, like coerced birth or involuntary sterilization, may constitute acts of genocide by preventing births.”

Additional Hotspots

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 struck a baby care unit, causing fatalities among patients and staff.

In Myanmar, medical facilities have been bombed 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

A large proportion of mother deaths are preventable with routine care, but war collapses medical infrastructure. Rights groups note that terror is compelling women away from facilities once considered safe, resulting in risky home births lacking professional help.

“When childbirth centers become intentional targets indicates a broader and more sinister pattern: the use of attacks on medical facilities as a tool for terror and to tear apart the social fabric,” says a legal researcher.

“Hospitals are not completely safe for hospitals in war. Under the Geneva conventions, medical facilities can lose their protected status if used for acts deemed ‘militarily advantageous’, which has now become a standard defence.”