Joy and sorrow are almost inseparable for Alyona Hvrilenko. A few days ago, the 28-year old gave birth  to a daughter. Daryna is fast asleep in a bassinet next to her mother's hospital bed. Hvrilenko can hardly believe how fundamentally her life has changed in the past few weeks. Heavily pregnant, she was on maternity leave already when the Russian military invaded Ukraine on February 24. "Suddenly sirens went off and we heard the first explosions," recalls the young mother, who at the time was living in the capital, Kyiv, with her husband. It was scary, because they had no idea what was going on, she says, adding there was no information on TV yet.

Pregnant refugee

The couple watched more and more neighbors hurriedly loading packed suitcases into their cars and driving away. That afternoon, they too decided to leave. "Oddly enough, we hadn't purchased anything for the baby, no crib, no changing table, nothing. It was almost as if deep down, we already felt something," Alyona Hvrilenko says. After a weeks-long odyssey, the couple finally reached Lviv in western Ukraine, where they stayed with relatives. Air-raid sirens wail in Lviv almost daily, too, but the city is still considered to be relatively safe. The front, the occupied territories and the Russian artillery — all of that is hundreds of kilometers away.

Fleeing in her condition meant giving up all plans to give birth in familiar surroundings and with the support of her family. In Lviv, she scoured the internet to find information on whom to turn to as a pregnant woman and came across the maternity clinic at the regional hospital in the center of the city. "Their very first examination showed that our daughter was growing very slowly," the young mother recalls, adding she was not really surprised.

After the outbreak of the war, she fell into the deep hole of depression and was unable to eat much of anything at all for weeks.

Not enough incubators

Alyona Hvrilenko and her husband were lucky — their daughter Daryna was born healthy and almost on time. Since the outbreak of the war, there has been a steep rise in medical complications in pregnancies. The number of premature births has skyrocketed in particular, health experts report a threefold increase in some of the cities that are targeted by attacks more than others. According to local doctors in the embattled city of Kharkiv in the northeast, as many as one in two deliveries was premature in the first weeks of the war. In many hospitals, that resulted in a shortage of incubators, which can be vital for the survival of premature babies.

The Lviv maternity hospital has also seen a significant increase in premature births, mainly among mothers who have already been on the run for a while. Galina Golets' room is down the hall from Alyona's. Her son Mykailo was born more than a month premature. "He still has to be fed via a tube, he's too weak for the bottle," Galina told DW. "But he can already breathe on his own and I feel he is slowly getting stronger."

At least she feels relatively safe in Lviv. Her native Mykolaiv is in the embattled south of the country, a few hours' drive from the almost completely destroyed city of Mariupol, where several people were killed during the shelling of a maternity clinic in the first weeks of the war. "The stress we experienced in the past weeks was just unbelievable," Galina says, adding that to make matters worse, she had COVID-19 twice.

'Stress has a negative impact on pregnant women'

Those are typical factors that lead to a rise in premature births, according to Maria Malachynska. The gynecologist and head of the maternity clinic in Lviv has recorded more than 200 births at her facility since the war began — more than ever before.

"Any form of stress has a negative impact on pregnancy," she says, adding that of course the current situation, the war, is extremely stressful. "The outbreak of war was a huge shock, and now there's added uncertainty about the future." The difficult circumstances on the run and the cramped conditions in many air-raid shelters also increase the risk of infection, she says.

In addition to medical care, many mothers need psychological support. The gynecologist says she tries to protect her patients from negative influences and advises them to follow the war in the media as little as possible. Of course, that is often not possible, she says, adding that the women want to know how their families are doing. The Lviv clinic does not suffer from medical shortages, which is also due to the fact that the clinic reached out for support early on, including aid from other European countries, Malachynska says. Three new incubators arrived just a few days ago, she says. "We can't predict anything in the current situation, but we have to continue to be prepared for everything."

The young mothers do not know what their lives will be like when they leave the hospital with their newborns. "We probably won't be able to return home anytime soon," Galina says, adding that "is all I can say about our future right now."

This article has been translated from German.