The Targeting of Childbirth: How Women and Babies Became Targets in Global Conflicts.

Dozens of women were seeking shelter in a childbirth facility in El Fasher, Sudan, as the slaughter began. 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, managed to survive the ordeal. “There were cries of women and children,” he recounts. “A massacre was taking place inside the hospital. Survival meant running for your life.”

This appalling incident stands as a particularly egregious examples in the protracted internal conflict tearing the African nation apart. Militiamen stormed the facility, allegedly slaughtering more than 460 innocent people inside.

Rights organizations have described it as “an unspeakable atrocity,” and a clear case of the deteriorating protection for civilians caught in conflict zones in multiple global hotspots.

A Record of Violence Against Maternal Care

Although world powers have agreed to the Geneva conventions, which commit them to defending civilians, the past year has experienced a historic high of assaults against medical infrastructure. Expectant mothers are exceptionally vulnerable due to their dependence on locally available medical care.

Research and compiled data reveal an shocking trend: nearly 300 attacks on and disruptions to 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 standard wartime hazards. They form a pattern of reproductive violence.”

The majority of these assaults have occurred in regions embroiled in intense conflict, where hundreds of thousands of pregnant women are trapped.

Women have been killed, blocked from reaching help, or compelled to deliver in deplorable situations. The data also indicates that at least 68 childbirth professionals and specialists have been slain, 15 kidnapped, and 101 taken into custody—sometimes while assisting births.

The Global Crisis in Maternal Health

Statistics are thought to be a significant underestimate, as they capture solely incidents reported in news outlets. In many conflict zones, information is scarce.

Last year, analysis showed that half of all women who died during pregnancy or childbirth were in a conflict area. This underscores a horrifying trend.

In addition to the loss of life, these attacks are obliterating hospitals and wards, jeopardizing the future 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 one reason behind declaring certain actions a genocide.

Despite periods of calm, 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.

“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 aiming to influence birthrates.

Ukraine's Ordeal

Since early 2022, at least 80 hospitals for mothers and babies have been damaged or destroyed in Ukraine. Accounts from embattled medical centers describe births occurring in shelters and extreme psychological pressure leading to problems during delivery.

“Russia is targeting us deliberately,” says the head of obstetrics at a repeatedly damaged hospital in Kherson. Officials from Russia have rejected deliberately targeting civilians.

“The reality is, every facility faces the threat of assault,” notes a medical director in Sumy. “When defensive systems shoot down an aircraft, the falling debris may hit a hospital.”

Accountability Evaporates

For the hundreds of millions of women living within range of fighting, there are minimal protections and even fewer war crimes prosecutions for those assaulting reproductive health.

This lack of accountability has fostered a “environment where anything goes,” 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.”

Additional Hotspots

In El Fasher, the area was isolated 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 limited by a inability to report from rebel-held areas. Nevertheless, shelling in Goma hit a neonatal ward, resulting in tragic loss of life.

In Myanmar, clinics have been attacked and dozens of midwives and patients have suffered violence over the past two years of civil war.

The End of Safe Deliveries

Most maternal deaths are avoidable with standard medicine, but war collapses medical infrastructure. Rights groups note that fear is now driving women away from facilities once considered safe, pushing them toward risky home births lacking professional help.

“The deliberate attack on maternity wards speaks to a broader and more sinister pattern: the use of attacks on medical facilities as a means of intimidation and to destroy community bonds,” says a legal researcher.

“There is no absolute protection 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 now become a standard defence.”