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

MYKOLAIV, Ukraine – Amina Tsoi’s twins are healthy girls.

They argue, as do their brothers, and both have a curious appetite for cheese, “like little mice,” says their mother.

But they are small to be a year old, a legacy of their own premature birth during the first weeks of the Russian invasion of Ukraine.

For seven months, Tsoi had enjoyed a happy and healthy pregnancy with virtually no complications.

Then, one February morning last year, explosions hit the town where he lived near Mykolaiv in southern Ukraine, which was facing an escalation of rocket attacks and ground skirmishes.

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

Tsoi, then 20, escaped the bombing and appeared unharmed.

But in the days that followed, he lost the sight in one eye and gained 14 pounds from holding water.

After an emergency caesarean section, during which she lost so much blood that she required 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 more.

The mental burden of war has also taken a heavy toll.

risks

For pregnant women, stress can be especially dangerous, and doctors and hospital officials are warning of a sharp increase in maternal health problems, such as premature births.

Babies born before term are more likely to develop respiratory, neurological, and digestive complications.

Particularly premature babies can have serious physical and mental health problems.

Twins or other multiple births are likely to be born prematurely, even in normal times.

After more than a year of war, official statistics on maternal health in Ukraine are poor.

Data on premature births, for example, can be misleading because many pregnant women, especially those with poor health, were evacuated to other countries after the Russian invasion began.

But the doctors interviewed, especially in areas close to the fighting, reported high rates of premature births, higher cases of hypertension during pregnancy and a higher rate of caesarean sections, accusing the complications to the extraordinary stress of having a child in a moment of danger and uprooting.

“We see that the course of pregnancy has become tougher,” says Dr. Liudmyla Solodzhuk, 58, the medical director of a hospital in Mykolaiv, a town near the front.

“Normally, the birth of a new human being is happiness, and now it is anxiety“, He added.

The effort to protect pregnant women from the stresses of war has become a medical priority, Solodzhuk said, with medical staff looking for new ways to distract patients from the brutal sounds of war outside.

“We said the bombings are fireworks,” he said, “in honor of the birth of your children.”

Solodzhuk hospital in Mykolaiv reported that the number of caesarean sections and preterm deliveries increased by 5%.

Government statistics show smaller increases in preterm births in the Mykolaiv region overall and in other parts of southern and eastern Ukraine where fighting is most intense, but these figures are complicated by the large number of residents who have fled.

The musical duo Tvorchi, Ukrainian participants in the Eurovision Song Contest held in Liverpool (England) last month, gave more publicity to the matter when, on a red carpet that preceded the contest, the performers wore costumes with the names and weights of babies born prematurely.

Threat

For the pregnant women left behind after the Russian invasion, any hope that the fighting would soon end proved illusory.

Inna Harbuz, then 30, was pregnant with twins and living in Mykolaiv when Russian missiles began attacking the city.

His family decided it would be safer to move elsewhere, but an early Russian advance took the nearby town they had gone to.

As much as possible, the family tried to remain inconspicuous.

“We started hiding in the basement every day, mostly out of fear that the Russians would find us,” Harbuz said, adding that the fear of being discovered by invading troops was worse than facing rocket fire at Mykolaiv.

On October 28, Harbuz suffered internal bleeding due to a placental abruption.

By then, Russian troops had already withdrawn from the city and her family rushed her to a hospital in Mykolaiv, where she underwent an emergency caesarean section.

Her twin sons, who were born prematurely, received assisted breathing.

Seven months later, both babies are fine.

But the family decided to stay in the village rather than return to Mykolaiv, which is still regularly bombed.

After the birth, Tsoi’s twins experienced health problems and she said she needed to have her heart rate, vision and weight checked regularly.

At 9 months they were still on their feet and the family was starting to worry, but “they’re both running now,” she said recently.

Tsoi blames the war for turning her pregnancy into an ordeal.

Even during the cesarean section, conflict was inevitable.

“I started crying on the operating table,” she says.

“It was very scary because I heard a lot of explosions and gunfire outside.”

She was not reunited with her daughters until the eighth day after giving birth.

At the time, they were still being fed through tubes and the fighting outside was getting worse.

At one point, hospital staff and patients were forced to huddle in the basement for safety.

The traumatic experience was almost too much for Tsoi.

“After a month, I had a horrible seizure,” she says.

“I yelled at my husband to take us abroad, otherwise I wouldn’t have made it, I wouldn’t have survived.”

Tsoi’s husband took the family to the Moldovan border, but they had to return to Ukraine, as men of fighting age cannot leave.

A few months later, Tsoi and her daughters returned to Ukraine and rented a house near Odessa to be closer to her husband.

The girls are healthy, but they are late normal growth goals and development for his age.

For Tsoi, the war transformed her pregnancy from a happy experience to one she would rather forget.

“I still can’t believe I survived,” he says.

c.2023 The New York Times Society