As Ukraine marks three years since Russia’s full-scale invasion, the impact on women, especially mothers, has become increasingly dire. The threat of missile and drone attacks has left pregnant women and newborns in constant danger, with the situation even more challenging in areas near the front line. High rates of premature births, limited access to medical services, and immense mental stress are affecting women and their families every day.
One such woman, 31-year-old Ira, was already raising a six-year-old son when she found out she was expecting triplets. Living in Kherson Oblast, a region frequently targeted by nighttime attacks, Ira and her husband faced a difficult decision: stay and endure the pregnancy amid constant shelling or leave everything behind to find safety. Ultimately, Ira gave birth prematurely, and though her babies needed intensive care, they survived and left the hospital. Her relief was shared by many Ukrainian mothers who continue to bring new life into the world despite overwhelming challenges.
However, Ira’s story highlights a broader crisis. Ukraine’s maternal health is under threat due to damaged hospitals, shortages of medical staff, and the ever-present risk of air raids interrupting childbirth or prenatal care. The national preterm birth rate in 2023 was 6%, but in conflict zones like Kherson, it rose to 11.8%, nearly double the national average. Kherson also has the highest stillbirth rate in the country. Doctors attribute these high rates to the extreme stress of living in such dangerous conditions.
To protect women in labor, bunkered maternity wards have been established in high-risk areas. In Kharkiv and Kherson, reinforced underground units are being set up to provide full perinatal services, even during attacks. Supported by the United Nations Population Fund (UNFPA), these facilities allow women to give birth without the need to leave the safety of the ward in the middle of labor.
The Kherson City Perinatal Centre, for example, has been hit by shelling three times since the invasion began, highlighting the vulnerability of medical facilities. By creating underground spaces, medical staff and patients can focus on care, without the constant threat of evacuation.
Despite the risks, medical teams in these areas remain committed. Some, like those at Kherson’s maternity hospital, have chosen to stay, knowing that leaving would mean no care for pregnant women who refuse to leave their homes. Many women prefer to stay in familiar surroundings and trust local doctors, even amidst the constant threat of bombings. There is a shared determination to maintain a sense of normalcy, despite the chaos surrounding them.
The war also brings a rise in psychological distress. According to the UN, 63% of households in Ukraine report experiencing mental health challenges, from anxiety to severe depression. For pregnant women, these added stresses increase the risk of complications and postpartum disorders.
The ongoing conflict also fuels gender-based violence (GBV), with economic instability and fear leading to intimate partner violence, domestic abuse, and sexual exploitation. An estimated 2.4 million people in Ukraine, most of them women and girls, require GBV prevention and support services. While the UNFPA provides some assistance, the demand continues to outpace available resources as the war drags on.
Protecting women’s health is vital to ensuring a strong future for Ukraine. Building bomb-proof maternity wards, offering comprehensive healthcare, and expanding mental health and GBV services can help mitigate some of the war’s harshest impacts. However, none of these efforts can replace what is truly needed: lasting peace. Peace is the foundation for ensuring the safety and well-being of mothers and newborns, and until it is achieved, the international community must continue to support Ukraine’s women and families, both above ground and below.
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