As Ukraine reaches the three-year mark since Russia’s full-scale invasion, the impact on women’s health — and especially maternal health — has grown increasingly dire. Missiles and drone attacks strike without warning, putting pregnant women and their newborns at constant risk. In areas closer to the front line, the challenges are even greater, with higher rates of premature births, a lack of consistent medical services, and overwhelming mental stress that reverberates through every aspect of daily life.
I recently learned of Ira, a 31-year-old mother already raising a six-year-old boy when she discovered she was pregnant with triplets. Living in Kherson Oblast, a region routinely targeted by nighttime assaults, she and her husband faced a terrifying dilemma: endure the pregnancy amid constant shelling or uproot their entire lives.
Ultimately, Ira gave birth prematurely. Though her babies initially required intensive care, they recovered and were able to leave the hospital. Her relief at their safe arrival mirrored the resolve of countless Ukrainian mothers who persist in bringing new life into the world despite difficult odds. Yet Ira’s story is part of a broader crisis. Maternal health is consistently threatened by damaged hospitals, infrastructure, staff shortages, and the simple but devastating reality that an air raid can happen at any moment — interrupting childbirth or prenatal care.
"Maternal health is consistently threatened by damaged hospitals, infrastructure, staff shortages, and the simple but devastating reality that an air raid can happen at any moment — interrupting childbirth or prenatal care."
According to 2023 data, the national rate of preterm births is around 6%, but in hard-hit regions such as Kherson Oblast, that rate rises to 11.8% — nearly double the national average. Kherson also has the highest stillbirth rate in Ukraine. Doctors working in these conditions consistently link high stress levels to the uptick in adverse outcomes.
Because of the environment, there is a need for bunkered maternity wards in areas close to the front lines. Facilities in Kharkiv and Kherson are setting up reinforced underground units designed to protect women in labor from shelling. These structures, supported by the United Nations Population Fund (UNFPA), the organization’s sexual and reproductive health agency, allow full perinatal services to continue even during attacks, relieving pregnant women of the need to relocate in the middle of childbirth.
The Kherson City Perinatal Centre, for example, has been hit by shelling three times since the invasion began — an unsettling reminder that medical facilities are still not safe. By creating safer underground spaces, staff and patients can focus on care rather than constant evacuation plans.
Medical teams in these vulnerable areas are brave. Some, like the staff at Kherson’s maternity hospital, have chosen not to leave despite the dangers. They know their departure could mean an absence of care for expectant mothers who decide to stay in their hometowns. As one obstetrician noted, many pregnant women refuse offers to relocate because they would rather remain in familiar surroundings and trust local doctors. There is a shared commitment to preserving a sense of normalcy — even when bombs continue to fall.
Unfortunately, the war does more than threaten physical safety. Psychological distress has become widespread. According to the UN’s humanitarian coordination office, 63% of households in Ukraine report at least one mental health challenge — ranging from anxiety to severe depression. Constant shelling, economic hardship, and the fear of future attacks compound these issues. For pregnant women, the added stress can increase the risk of complications and postpartum disorders.
Such an environment also increases the prevalence of gender-based violence (GBV). Economic uncertainty and relentless fear fuel intimate partner violence, domestic abuse, and sexual exploitation. An estimated 2.4 million people in Ukraine — most of them women and girls — need GBV prevention and response services. UNFPA supports these interventions, however, while the war continues, international actors, community-based organizations, and health providers struggle to meet the rising demand.
We know that safeguarding women’s health is essential for any nation’s future. Ensuring safe births today means ensuring a resilient generation tomorrow. By constructing bomb-proof maternity wards, delivering comprehensive healthcare, and expanding mental health and GBV services, Ukraine can mitigate some of the conflict’s harshest effects.
Yet none of these measures can fully substitute for the one factor that truly guarantees the well-being of mothers and newborns: lasting peace. Peace is the foundation on which we can work toward justice. Until it is achieved, we have a duty to support the well-being of women and families — on the surface and underground.
Editor’s Note: The opinions expressed in the op-ed section are those of the authors and do not purport to reflect the views of the Kyiv Independent.
Andriy Lyubka
