Ukraine’s war makes pregnancy riskier, mothers persevere despite chaos

A pregnancy in Ukraine now unfolds under air alerts, drone strikes and blackouts. Bombing and displacement have pushed maternity care into basements and shelters, yet women and clinicians keep showing up for labor, delivery and newborn care even when the front line is only a few kilometers away.

Pregnancy under fire

Russia’s full-scale invasion, launched in February 2022, has killed more than 15,000 civilians and injured more than 41,000, while also displacing millions and damaging civilian property and infrastructure. The United Nations human rights mission found civilian harm remained severe in 2025, with January-to-November casualties running 26% higher than in the same stretch in 2024.

The mission found that long-range missiles and loitering munitions accounted for 35% of civilian casualties in Ukraine in 2025, while short-range drones drove a 120% increase in civilian casualties compared with 2024. For maternity wards, that means danger no longer arrives only at the front line. It reaches city centers, basement shelters and the hospitals that expect to stay open through the night.

UNFPA links that pressure to pregnancy outcomes. Maternal mortality in Ukraine rose 37% from 2023 to 2024, a jump the agency links to violence, stress, displacement and disrupted care.

A country where deaths vastly outnumber births

The demographic strain is visible in official registration data. Ukraine recorded 176,679 births and 495,090 deaths in 2024, while the first half of 2024 alone saw 87,655 births against 250,972 deaths. That means deaths exceeded births by more than 318,000 in the full year, a gap that reflects both wartime mortality and the erosion of family formation under chronic uncertainty.

This imbalance shapes every maternity system in the country. When young families leave for safety, when pregnancies are interrupted by shelling and repeated moves, and when hospitals lose staff or equipment, the normal pipeline of prenatal checks, scheduled births and postpartum care becomes harder to maintain. In practical terms, that leaves fewer local support networks for pregnant women and more pressure on a smaller number of facilities that must keep functioning under threat.

The consequences are especially sharp in frontline areas in southern and eastern Ukraine, where access to obstetric care can hinge on whether roads are open, ambulances can move, and generators can keep monitors and incubators running. Bringing a child into the world now requires planning for sirens, fuel, evacuation routes and the possibility that the nearest safe room is underground.

Hospitals are moving childbirth below ground

Medical teams have responded by moving delivery rooms into reinforced shelters and underground spaces. The Kherson City Perinatal Centre’s underground ward handled 118 deliveries in 2024 and 110 more by late 2025, UNFPA found. The ward sits about 1.5 km from the active front line, where artillery and drone threats remain constant.

Kherson is not alone. Bunkerized or underground maternity units are being built or refurbished in Kherson and Kharkiv, while similar work is underway in other hard-hit areas. In Odesa, one maternity hospital had reinforced its air-raid shelter, and the city’s maternity system was facing a 12% rise in birth complications, the UN and UNFPA found in 2024.

A reinforced delivery room can keep a fetal monitor powered through a blackout, protect staff during shelling, and let a mother remain in the building rather than being moved through a city under fire. In a country where power outages can come alongside air strikes, the ability to deliver safely depends on architecture as much as medicine.

Shelters are becoming part of the labor unit

The war has also made basements and bunkers part of the maternity care chain itself. In early October 2025, a missile struck a UNFPA-supported maternity hospital in Sumy while more than 160 pregnant women, new mothers, newborns and health workers sheltered in the basement. In December 2025, a maternity hospital in Kherson was damaged in another attack.

The United Nations human rights office recorded at least 164 civilians killed and 910 injured in March 2025, and found that 94% of damage to educational and health facilities occurred in territory controlled by Ukraine.

Women keep choosing birth

Despite the threat, pregnancy continues. Emergency births in bunkers, basement wards and shelters are part of daily work for doctors and midwives in Kherson, Sumy and Odesa, not an exceptional event. One woman put the determination bluntly: “We must bring new life.”