On October 14, Olena’s life changed completely. The day before, she had been a soldier serving her country along Ukraine’s frontline. Now, she was also a mother.
As she rocked her newborn, a daughter she’d named Sofiia, Olena, who asked that we only use her first name, described the emergency cesarean section she had the night before, after she developed preeclampsia. She’d been brought to the maternity ward at Hospital No. 25 in Kharkiv, Albuquerque’s newest Sister City. After a successful delivery, she named her daughter Sofiia because she liked the sound of the name combined with her daughter’s patronymic, a traditional middle name based on her father’s first name: Sofiia Mykhailivna.
Olena is one of a shrinking number of women giving birth in Kharkiv as the war in Ukraine wears on. In 2024, Ukraine recorded the lowest birth rate in the world as families navigated the risks of being pregnant and raising children four years into an ongoing conflict. At Kharkiv Hospital No. 25, a dedicated corps of local doctors, nurses and paramedics keep childbirth as safe as possible – despite the ongoing threat of shelling.
Organizations and people in New Mexico have sent supplies and even medical volunteers to Ukraine since the war began. But it could also draw some lessons from Albuquerque's sister city. Providers in Kharkiv have created a tool that providers here may find interesting, given the state’s growing maternity care deserts: a mobile maternity unit that can serve women in areas far away from hospitals.
Dr. Vitalii Kucher, an OB/GYN, ventures outside of Kharkiv in one of these ambulance-like units, donated and equipped by the UN. When he began traveling out of the city with such teams in January 2023, their first goal was to reach communities in formerly occupied territories -- areas where residents had gone without health care for months. Kucher and his colleagues perform ultrasounds, screen for cervical cancer and draw blood for HIV and Hepatitis tests out of the mobile unit, which has incubators, sterile neonatal equipment and even generators so they can run even when the electricity goes out, which is common as Russia continues to target Ukraine’s power infrastructure.
They’ve continued that work despite the growing threat of deadly First Person View (FPV) drones. “I'm worried, I won't deceive anyone,” Kucher said, before departing for a trip to the village currently nearest the Russian position. “When you go to such communities, the threat always remains. But we're working.”
Even in larger cities like Kharkiv, doctors have had to improvise to deliver care. Dr. Serhii Alkhimov, 25, organized a medical unit in a local metro station at the beginning of the full-scale war, when Russia occupied neighboring villages and Kharkiv fell under constant shelling. Now, he performs ultrasounds and deliveries at Hospital No. 25, alongside Dr. Iryna Borzenko.
“Thank God, we have not yet had any cases of maternal mortality,” said Borzenko, chief of the hospital’s neonatal care unit. But the birth rate has plummeted and diseases that occur during pregnancy are on the rise, she said. In 2025, the hospital has recorded three times fewer births than in 2021, before Russia’s full-scale invasion; and she added that stress is causing heightened rates of preeclampsia, hypertension and pre-term birth.
Through its work in Ukraine, the UN Population Fund, the sexual and reproductive health agency of the United Nations, has tracked the rise in pregnancy-related diseases since the start of the full-scale war in 2022. According to the agency, cases of preeclampsia went up 12% and the number of uterine ruptures increased 44% between 2023 and 2024. The cesarean section rate, which the World Health Organization recommends remains around 10 to 15%, is triple that in frontline cities, 34% in Kharkiv.
That threat of diseases caused by stress has motivated sanitary nurse Zhanna Kurylko to ensure all visitors to the hospital are wearing gowns, masks, boot coverings and hair nets. “People understand, invasion is stress,” she said.
Even without the risk of pregnancy-related diseases, childbirth itself has become more dangerous. Since February 24, 2022, Russia has struck Ukrainian health care facilities more than 2,700 times. More than 80 of those attacks have targeted maternity hospitals, according to the UN Population Fund.
Women living in frontline cities, like Kharkiv, face the fiercest shelling and highest levels of stress. But there are many reasons why they don’t leave.
“Pregnant women want to be with their families, they don't want to relocate because they have all their support systems around them,” said Jacqueline Mahon, the UN Population Fund’s representative to Ukraine. “They have their older parents that they want to look after, they have their homes there.”
Borzenko said many of the women she treats at the Kharkiv hospital have already moved from villages even closer to the front. Others simply cannot afford to move.
Although she could have left her hometown when Russia invaded in 2022, Borzenko chose to stay. “If all the doctors are leaving, what is the population supposed to do?” she said.
Although the number of women giving birth in Kharkiv and the surrounding region has fallen, mothers like Olena still cradle their newborns as they recover from their first sleepless nights – while local physicians and humanitarian organizations try to keep them both safe.
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Liubov Sholudko contributed reporting and translation support.
This reporting was supported by the International Women’s Media Foundation’s Women on the Ground: Reporting from Ukraine’s Unseen Frontlines Initiative in partnership with the Howard G. Buffett Foundation.