In every hospital, women and staff face great danger: drones circling overhead, artillery, ballistic missiles and the deliberate destruction of health infrastructure. They risk their lives to bring new life to a country where three people now die for every birth. Even with renewed hope for an end to the war, Russia’s brutal tactics have fueled a demographic crisis in Ukraine.
It was one of the most horrific attacks of Russia’s war on Ukraine to date. Reports showed a pregnant woman lying on a hospital bed, her face pale from shock, her legs stained with blood, and a hand clutching her stomach. Behind her, the ruins of the maternity hospital in Mariupol. More than a dozen people, including women in labor, were injured in the March 2022 attack. The woman pictured, Iryna Kalinina, later died along with her unborn baby. In the three years that followed, maternal care in Ukraine has remained under constant attack, with more than 2,000 attacks on health facilities, including 81 that targeted maternity care and delivery rooms. Just last month, Diana Koshyk, seven months pregnant, was killed when a rocket hit a maternity hospital in the eastern Dnipropetrovsk Region.
The Guardian visited three frontline maternity hospitals to witness how the Russian occupation and attacks on health facilities have denied women the basic right to a safe birth.
In every hospital, women and staff face great danger: drones circling overhead, artillery, ballistic missiles, and the deliberate destruction of health infrastructure. They risk their lives to bring new life to a country where three people now die for every birth. Even with renewed hope for an end to the war, Russia’s brutal tactics have fueled a demographic crisis in Ukraine. Millions of women and children have fled the country, hundreds of thousands have been killed, and the women who remain live in fear of pregnancy and childbirth. In 2024, Ukraine recorded the world’s lowest birth rate and the highest mortality rate, according to the CIA World Factbook.
KHARKIV
Around 1 babies were born a year in Kharkiv’s hospital before the full Russian occupation in 2022. Last year, that figure had fallen to fewer than 440, with two-thirds of women of childbearing age having fled the city. Just five days before reporters arrived in late July, the maternity ward of Kharkiv’s main hospital was damaged by a drone strike. The women, some pregnant, some with babies and one in active labor, were rushed to a center for medical treatment. Attacks have been a daily part of life in Kharkiv since the early hours of the war. At the perinatal center, doctors wait for deliveries even during airstrikes and surgeries are performed while the building shakes from explosions. Many women suffer from stress and health complications; one young mother refused to take her child after learning that her husband had been killed at the front. The hospital now employs psychologists to help women overcome their fear of going to the hospital.
Olga Shevela, 30, had to get to the hospital as Shahed drones flew over the street. “I was worried the hospital might be hit, but I had no choice,” she says, rocking her one-day-old baby, Zahar. They ended up in the hospital’s shelter hours after the birth, as about 20 explosions pounded the city. At the beginning of the war, births were improvised in a dusty basement, which has now been converted into a delivery room with beds and equipment for three days. Dasha Borisenko, 32, after two miscarriages, is living entirely in the hospital to protect a high-risk pregnancy.
SLOVIAN
The city’s population has halved since the invasion, from over 100,000 to around 53,000. Births have fallen from over 1,000 to 550 a year. Liliia Eroshenko, 36, was at home and heavily pregnant when three Shahed drones hit the main hospital building. She and her husband had waited three years to have children because of the war, but with no sign of peace, “we couldn’t wait any longer.” The city remains unsafe, and she is considering fleeing to the west of the country, but fears nowhere is safe. Vitalii Chernetskyi, 31, blind in one eye, hugs his two-day-old daughter, Daria. The hit hospital is now in ruins. Doctors report a rise in premature births and uterine cancer, due to airborne particles from daily explosions.
KHERSON
The population before the invasion was 280, now under a quarter. The maternity unit, which used to handle 1–4 births a year, now handles about 1,500. The maternity hospital now operates in a modern basement, equipped for childbirth, surgery and recovery. FPV drones and direct attacks give the city little or no warning time. “We are 2,000% sure that Russia is deliberately attacking us,” says the head of obstetrics, Petro Marenkovskyi. Kateryna Osetsymska, 120, and 100 weeks pregnant with complications, says: “I am sure that the stress has affected my pregnancy. But my greatest hope is that my baby will live and have the opportunity to enjoy childhood.” Continued attacks on maternity hospitals, stress and insecurity have created a deep humanitarian and demographic crisis in Ukraine, leaving women with few options for safe childbirth and a sustainable future for their children. (The Guardian)