Ukrainian refugees confront increase in pregnancy complications

After undergoing an emergency procedure to save the stronger of the twins, Pohrebna thought she was in the clear. But then she went into labor at just 29 weeks. After delivering birth to a girl named Valeria, doctors said the baby had hemorrhaging in her brain and would need to spend a few months in the neonatal intensive care unit. The full extent of Valeria’s brain damage will not be known until she is 5 years old.

“It has been very traumatic,” said Pohrebna, who now travels an hour every day on the bus to visit Valeria in the hospital. “I try to focus on what I have right now, not what I could have had.”

“I try not to think about the other child,” she said.

Pohrebna’s case is not uncommon. 

While no data is available yet, doctors in Poland say they are seeing higher rates of pregnancy complications, premature births and stillbirths among Ukrainian refugees due to severe physical and emotional stress and prolonged periods of limited access to health care.

Many pregnant refugees arriving in Poland have been sitting in crowded bomb shelters for weeks in unsanitary conditions, with little access to reliable food, water or electricity. Some have had to walk nearly 20 miles to cross the border, carrying luggage and young children.

Around the world, maternal health care suffers amid war as women are forced to flee their homes, doctors are diverted to wartime response efforts and hospitals are left vulnerable to attacks. In Ukraine alone, the World Health Organization said it has verified more than 100 attacks impacting health care since the start of the war, including attacks affecting medical facilities and supplies. 

Collecting data on the impact of war on pregnant refugees in any conflict zone can often be difficult due to the small sample size and issues with underreporting. The outcome of pregnant refugees and their babies can also vary widely depending on the health care services being provided in host countries, said Ann Burton, the chief of public health at the United Nations refugee agency.

“We know that there’s probably going to be an increase in complications, but what’s most important is being able to put measures in place to be able to deal with those complications competently,” she said.

The United Nations Population Fund estimated that 265,000 Ukrainian women were pregnant when the war started, and 80,000 were expected give birth over the next three months.

Dr. Andrew Weeks, a professor of international maternal health at the University of Liverpool who has studied the risks of war for pregnant women, said while many babies are delivered without any issues, around 30 percent of all women typically develop complications during pregnancy, and another 20 percent need emergency care during labor.

Most of these issues can be detected through routine prenatal checkups, but when medical care is delayed and complications are left untreated, pregnant women are at an increased risk of premature births and other issues.

“The small things that are normally picked up progress and get worse and worse,” Weeks said. “The consequences are dire.”