The last maternity hospital in Ukrainian-controlled Donbass is a lifeline as the war ends

In the last specialized maternity hospital still under Ukrainian control in eastern Donbass, the windows are filled with sandbags.

Rooms used for births at the Pokrovsk City Perinatal Center follow the two-wall rule, which states that the safest parts of a building are separated from the outside by at least two walls.

“Sometimes we had to give birth during the shelling,” center head Ivan Tsyganok said.

“Work is a process that cannot be stopped.”

The centre, some 40km from the nearest front line, provides insight into the suffering that war inflicts on pregnant women – their anxiety about where they can give birth, fear about whether the hospital will be attacked and what doctors observed to be an increased rate of early labor.

Marina Tupata watches her six-day-old baby Sofia get checked inside the hospital.(Photo: Reuters/Marko Djurica)

Dr Tsyganok fears the stress of living under Russian attack has led to a spike in premature births, a fear supported by initial data from the center and seen elsewhere in conflict zones.

Russia denies targeting civilians, but many Ukrainian towns and villages have been left in ruins as Europe’s biggest conflict since World War II nears the five-month mark.

Moscow says it is carrying out a “special military operation” to disarm Ukraine and defend Russian speakers from persecution by nationalists – an allegation dismissed by Kyiv as a baseless pretext for an imperial-style land grab.

Katya Buravtsova’s second child, Illiusha, was among those born early, giving birth at just 28 weeks. He would have had “no chance” of survival without the centre, Dr Tsyganok said.

A nurse stands with folded hands next to a baby in a hospital bed.
A nurse monitors baby Illiusha, who is doing well thanks to an incubator and the care he has received.(Photo: Reuters/Marko Djurica)

But thanks to an incubator and the care he received at the clinic, he is fine now.

“We looked after him around the clock,” said Dr Tsyganok, wearing teal scrubs and Crocs.

A woman in a blue hospital hairnet hugs her baby to her chest and looks up with a worried expression.
Illiusha is Mrs. Buravtsova’s second child.(Photo: Reuters/Marko Djurica)

Comforting her baby son, Ms Buravtsova, 35, said she did not know how she was going to give birth after the shelling of her village, near the front town of Kurakhove.

“You could be forced to give birth in a cellar,” she said.

Premature babies

In 2021, about 12% of just over 1,000 babies born at the center were born before 37 weeks of pregnancy, according to data from Dr Tsyganok.

This rate – compared to a Ukrainian average of around 9%, according to the World Health Organization – was typical of previous years in the center.

Since the February 24 invasion, 19 of 115 babies born in the hospital were premature, a rate of about 16.5%.

A baby is photographed in a hospital crib with a blue light shining on her.
Elena Derdel checks on her daughter, Vanhelia.(Photo: Reuters/Marko Djurica)

The total number of births was low because many women had fled, Dr Tsyganok said.

He established the center in 2015, a year after Russian proxies seized large swathes of Donbass.

Donetsk, the largest city in the region and home to a large maternity hospital, fell under the control of the self-proclaimed Donetsk People’s Republic in 2014.

Doctors at the new center have anecdotally observed that the simmering conflict, which is expected to kill more than 14,000 people between 2014 and 2022, is impacting pregnancies.

Doctor Ivan Tsyganok sits at a desk and looks out the window with a sad expression.
Dr. Tsyganok’s team must deliver babies no matter what happens outside. (Photo: Reuters/Marko Djurica)

Obstetrician Olesia Kushnarenko set out to prove it in 2017, conducting research for a doctoral thesis on how wartime stress in pregnant women affects the placenta.

Her study followed 69 otherwise healthy women who lived near fighting and were rated as having high levels of stress during their pregnancies.

More than half of the women had placental insufficiency – when enough oxygen and nutrients are not transferred to the fetus – a rate four times higher than that seen in a control group of 38 women.

Dr. Kushnarenko also found higher rates of complications, including premature births, in babies born to highly stressed mothers.

Now in Spain with her two children, she predicts the current conflict will have an even greater impact on pregnancies.

“This war is much hotter than before. It’s very dangerous all over Ukraine,” she said.

Mariupol Hospital

Dr Tsyganok said sandbags on windows would not save the clinic and its patients in the event of a direct hit, such as that at a hospital in Mariupol in March.

Sandbags are stacked against the inside of a window in a hospital.
Sandbags are piled at the windows of the hospital. (Photo: Reuters/Marko Djurica)

There, at least three people died when a Russian missile hit the hospital, sending pregnant women, some injured by shrapnel, fleeing in hospital gowns, according to Ukrainian authorities and press pictures.

The Russian Defense Ministry denied bombing the hospital and accused Ukraine of masterminding the incident.

With the disappearance of the Mariupol center and the closure of another near Kramatorsk, the Pokrovsk facility now serves the remaining population of the Ukrainian-controlled Donetsk region, around 340,000 people, according to the regional governor .

Among those present at the center in Pokrovsk was Viktoriya Sokolovska, 16, who was expecting a baby girl.

“The shooting gets on my nerves,” she said late last month, when she was 36 weeks pregnant and doing her best to stay calm.

She feared that “all the nervousness would pass to the baby”.

She has since given birth to a healthy daughter, Emilia.


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