The heartbreaking reality of giving birth in a war zone

Mariia Malakhovetska faced a unique challenge when she went into labor at 2 am in her village north of Ukraine’s Kharkiv. Concealing her pregnancy from Russian soldiers who had occupied the area, Mariia and her husband, instead of heading to a hospital, navigated the darkness to reach a local doctor’s home. Armed only with a stethoscope and a medical textbook from 1979, the inexperienced doctor assisted in the delivery.

Her predicament unfolded a month after Russia’s full-scale invasion of Ukraine on February 24, 2022. Eight months pregnant, Mariia attempted to flee with her in-laws to the city, but the arrival of soldiers thwarted their escape. With the nearest clinic ill-equipped for deliveries due to power shortages caused by the conflict, Mariia found herself facing childbirth alone.

Approximately 265,000 pregnant women were in Ukraine when the war began, with over 1,220 verified attacks on healthcare facilities reported by the World Health Organization. Amid the chaos of the initial three months of fighting, around 80,000 women, like Mariia, coped with giving birth in basements and bomb shelters.

Pregnant women in conflict zones endure severe disruptions to healthcare, including depleted drug supplies, absent medical personnel, power outages, water shortages, and direct attacks on maternity hospitals. This vulnerability is exemplified by instances in Kabul, Afghanistan, in 2020, and Mariupol, Ukraine, in 2022. Moreover, women may become pregnant in wartime as a result of rape.

The UN Population Fund (UNFPA) expressed “critical concern” for women and girls in Gaza, where 50,000 were pregnant at the beginning of Israeli bombardment, leading to an extraordinary challenge of 180 women daily needing to give birth amidst the total collapse of the healthcare system.