‘Lots of explosions and shooting outside’: Giving birth in wartime Ukraine

Amina Tsoi’s twin babies are healthy girls. They squabble, just like siblings, and they both have a curious appetite for cheese, “like little mice,” says their mother. But they are small for 1-year-olds, a legacy of their premature birth during the first weeks of the Russian invasion of Ukraine.

For seven months, Mrs. Tsoi had had a happy and healthy pregnancy, largely without complications. Then, one morning in February last year, explosions rippled through the town where she lived, near Mykolaiv, in southern Ukraine, which was experiencing increasing rocket attacks and skirmishes on the ground.

“My mother-in-law came into our room and said, ‘The war has started,'” Ms Tsoi said. “And I started to panic.”

Ms. Tsoi, then 20 years old, escaped any bombing and appeared unharmed. But over the next few days, she lost vision in one eye and gained 14 pounds because she was retaining water. After undergoing an emergency c-section, losing enough blood to require two transfusions, her daughters, born six weeks premature, clung to life in incubators.

The Russian invasion of Ukraine killed tens of thousands of soldiers and civilians and injured many thousands. The mental burden of the war has also taken a heavy toll. For pregnant women, the stress can be particularly dangerous, with doctors and hospital officials warning of a sharp rise in maternal health problems, such as premature birth.

Babies born before full term are more likely to have respiratory, neurological, and digestive complications. Premature babies in particular can have serious physical and mental health problems. Twins or other multiple births are prone to being born early even in normal times.

After more than a year of war, official statistics on maternal health in Ukraine are scarce. For example, figures on premature births can be misleading because so many pregnant women, especially those with health problems, were evacuated to other countries after the start of the Russian invasion. But doctors in several interviews, particularly in areas close to the fighting, reported an increased rate of preterm birth, more cases of high blood pressure during pregnancy and a higher rate of caesarean sections, blaming the complications on the extraordinary burden of giving birth. a child at the end of pregnancy. a time of danger and disruption.

“We see that the course of pregnancy became more difficult,” says Dr. Liudmyla Solodzhuk, 58, medical director of a hospital in Mykolaiv, a town close to the frontline. “Usually the birth of a new human being is happiness, and now it’s fear,” she added.

The effort to protect pregnant women from the stresses of war has become a medical priority, Dr. Solodzhuk, with medical staff trying new ways to distract patients from the relentless noises of the war outside.

“We said the shootings are fireworks,” she said, “in honor of the birth of their children.”

The Hospital of Dr. Solodzhuk in Mykolaiv has reported a 5 percent increase in caesarean sections and premature births. Government statistics show a smaller increase in premature births in the wider Mykolaiv region and in other parts of southern and eastern Ukraine, where fighting is fiercest, but those figures are complicated by the large number of residents who have fled.

The musical duo Tvorchi, Ukraine’s entry to the Eurovision Song Contest in Liverpool, England, last month brought further attention to the issue when the performers wore suits with the names and weights of babies at a red carpet event leading up to the contest. born early.

For the pregnant women who remained after the invasion of Russia, any hope that the fighting would soon be over proved desirable.

Inna Harbuz, then 30, was pregnant with twins and living in Mykolaiv when Russian missiles began hitting the city. Her family decided it would be safer to move elsewhere, only for an early Russian advance to take the nearby village they had gone to. The family tried to stay out of sight as much as possible.

“We started hiding in the basement every day, mainly because we were afraid that the Russians would find us,” said Ms. Harbuz, adding that the fear of being discovered by the invading forces was worse than the rocket fire in Mykolaiv.

On October 28, Ms. Harbuz began to experience internal bleeding due to a prematurely detached placenta. By then, Russian troops had been pushed back from the village and her family rushed her to a hospital in Mykolaiv, where she underwent an emergency caesarean section. Her premature twin sons were put on a ventilator.

Some seven months later, both boys are doing well. But the family has decided to stay in the village rather than return to Mykolaiv, which continues to be bombed regularly.

After Ms Tsoi’s twin girls were born, they had health problems and she said she had to check their heart rate, eyesight and weight regularly. At 9 months old, they still couldn’t stand it and the family was worried, but “they’re both running away now,” she recently said.

Mrs. Tsoi blames the war for making her pregnancy such an ordeal. Even during her cesarean section, the conflict was unavoidable. “I started crying on the operating table,” she said. “It was very scary because I could hear a lot of explosions and shots outside.”

She was not reunited with her daughters until the eighth day after giving birth. At that point they were still being piped and the fighting outside was getting worse. At one point, the hospital staff and patients were forced to cram together in the basement for safety.

The traumatic experience was almost too much for Ms. Tsoi. “Within a month I had a terrible breakdown,” she said. “I yelled at my husband to get us abroad or I can’t handle it, I just won’t survive.”

The husband of Mrs. Tsoi drove the family to the Moldavian border, but he had to return to Ukraine because fighting-age men are not allowed to leave.

A few months later, Ms. Tsoi and her daughters moved back to Ukraine and rented a house near Odessa to be closer to her husband. The girls are healthy, but are behind normal growth and development goals for their age.

For Ms. Tsoi, the war turned her pregnancy from a joyful experience into one she would rather forget.

“I still can’t believe I survived,” she said.