In the terrifying first days of Russia’s full-scale invasion, Inna Slavhorodska fled her home in eastern Ukraine and made it to Germany, miles from the bombs and gunfire.
Ms. Slavhorodska, now 38, was pregnant at the time. After her escape, she miscarried at five months, losing the baby.
Fighting raged on. Ms. Slavhorodska still wanted a baby, even though she was convinced that war-related stress had made her lose one already. She returned home to the city of Kharkiv, where Ukraine’s military had pushed back Russian forces in late 2022, and again became pregnant.
This January, she gave birth to a healthy baby through a C-section. The next day, Russian drones hit the hospital where she was recovering, causing damage but leaving Ms. Slavhorodska and her newborn unharmed.
“It was very scary,” she said. “Really scary.”
The war, which started with Russia’s full-scale invasion in February 2022, is inflicting an additional toll on pregnant women through fear and stress caused by bombings, shelling, displacement, occupation and electrical blackouts.
Maternal mortality in Ukraine increased by more than a third from 2023 to 2024, the most recent years of statistics available, according to data compiled by the World Health Organization and partners, and cited by the United Nations. The U.N. attributed the rise to attacks on health care facilities, stress and displacement, a finding supported by interviews The New York Times conducted with more than 40 women and more than a dozen Ukrainian doctors.
The number of children born in Ukraine has decreased every year since the war began. More than 168,000 children were born in Ukraine last year, down from nearly 274,000 in 2021, according to statistics from Ukraine’s Justice Ministry. The data does not include Crimea, which Russia annexed in 2014, or Russian-occupied territories.
The drop is partly because births by women who had become refugees in Europe were not being registered in Ukraine, experts say, and some women have delayed plans to have a family because men are in the army. But doctors say wartime stresses have also played a role because it has become so much harder to be pregnant and to give birth.
As of December 2025, more than 80 maternity and neonatal care hospitals in Ukraine had been damaged or destroyed, according to U.N. statistics. Some cities have no maternity wards left.
Many hospitals have moved operating rooms and beds into basements. Thousands of births now take place underground. The United Nations has helped hospitals near the front line build bomb shelters equipped as delivery rooms.
In January, when air alerts warned of approaching missiles or drones in the city of Dnipro, women in the maternity ward took their newborns into the corridor, away from windows that might shatter. Frightened and physically weakened so soon after giving birth, they did not know whether to stay there, or head to a shelter.
In Kharkiv, Anastasia Lotkova, 25, turned to a ritual to help her ignore explosions during her pregnancy — sitting in her bathroom, covering herself with a blanket, plugging her ears and screaming at the top of her lungs.
“Just to not hear those sounds,” she said.
Russia’s targeting of power stations led to regular electricity and heating outages in the Kharkiv region this winter, forcing Ms. Lotkova to wear multiple layers as the temperature in her apartment dipped to 46 degrees Fahrenheit.
Conditions are also difficult for pregnant women in Ukraine’s army, where roughly 70,000 women serve. Uniforms do not fit a big belly. Military doctors are ill-equipped for prenatal care.
Iryna Dolhopolova, 31, gave birth in January to a healthy daughter after serving as a medic until her seventh month in some of the most dangerous frontline sectors. Her job was to evacuate injured soldiers as drones flew overhead. Ms. Dolhopolova and her husband, who met in the army, already have two older daughters.
“We must bring new life,” she said of their decision to have a baby despite the war.
Since Russia’s invasion, many Ukrainian doctors report an increase in premature births and miscarriages. There are no nationwide statistics, but some hospitals track the data locally. The World Health Organization defines preterm as “babies born alive before 37 weeks of pregnancy are completed.”
In 2021, before the war, 2.9 percent of births were preterm at the Clinical Perinatal Center of the Blessed Virgin Mary in Sumy, a northeastern city on the front line. Last year, that figure was 5.5 percent, according to Yulia Kovalenko, the hospital’s deputy director.
Aliona Ponomarenko, 28, is an explosive ordnance removal specialist who does the psychologically taxing work of clearing land mines. She and her husband dreamed of having a baby, but she had a miscarriage in 2022 and her husband was killed in action two years later. She still decided to get pregnant, even if the baby would not be from the man she loved.
“I want a child,” she said.
At 30 weeks, her water broke and she gave birth to a 3-pound, 5-ounce girl: Alisa.
Iryna Kostiuchenko, 36, who gave birth in an underground ward in Sumy, said that she felt well throughout her pregnancy, and that she was not stressed by the shelling. Still, her son was born prematurely at 36 weeks.
“My little boy, why are you crying?” she said when the doctor pulled the baby out and placed him on her belly.
Nana Pasiieshvili, the director of the Kharkiv Regional Clinical Perinatal Center, said many premature births since the war started were “associated with stress, with shelling, with alerts, with insomnia, with anxiety, with blood pressure that rises.” High blood pressure can contribute to placental abruption, she added, which can lead to premature births.
Doctors working in Zaporizhzhia, a frontline city, said recent newborns were more likely to be jaundiced, underweight or experiencing inflammation.
C-sections are also more common in frontline areas, where doctors try to deliver babies during lulls in shelling rather than risk prolonged labor under fire. In Zaporizhzhia, Liubov Yuferova, 39, had twin boys by C-section after her water broke prematurely. They were born at 32 weeks and placed in incubators.
Wartime risks worsened her stress, she said. Before she gave birth, a Russian missile strike had killed a pregnant woman at the same hospital, according to a doctor who said she had witnessed the scene.
In Kramatorsk, Russian bombing left few options for Iryna Diachenko, 39, who was 26 weeks pregnant. The city’s maternity ward had already been bombed. When she fainted and felt ill after shelling, she had to travel to a facility in nearby Sloviansk.
“Whenever I hear explosions, I pray they don’t bomb this maternity hospital,” Ms. Diachenko said, adding that she had not experienced a single night during her pregnancy without sounds of explosions or gunfire.
She gave birth to a healthy baby girl in May. A little over a month later, the maternity ward in Sloviansk — the last one operating in the part of the Donbas region still controlled by Ukraine — had to shut down.
Olena Mohiliuk, 25, miscarried a first time in 2022 when Russians occupied her hometown, then again after the town she fled to, about 20 miles away, was heavily bombed.
She got pregnant again in Kharkiv, where in January doctors urgently performed a C-section when she went into labor because her contractions were weak. She gave birth to a daughter, Sofiia, who was diagnosed with hypoxia and a disturbance in her fetal heartbeat but survived.
Ms. Mohiliuk only saw Sofiia the day after the birth, in the intensive care unit. Standing in a medical mask next to her daughter, who was attached to life-supporting equipment, tears filled her eyes.
“‘My little one, everything will be OK for us,’” she said. “‘You are so strong, my girl.’”
Nataliia Novosolova, Stanislav Kozliuk and Andriy Dubchak contributed reporting.
