Ukraine has responded to a surge in childbirth complications and maternal mortality with the construction of bomb-proof maternity wards in conflict-affected regions. These underground facilities aim to protect women and babies from shelling, blackouts, and healthcare disruptions that have become a dangerous norm since the war escalated in early 2022.
Among the key centers is the Kherson City Perinatal Centre, located near an active frontline, where the underground ward has already hosted a significant number of deliveries under wartime conditions. This site has experienced direct shelling multiple times, yet it continues to function as a critical lifeline for pregnant women. The surrounding conflict and related stressors have contributed to a maternal death rate increase of 37 percent over one year, reaching nearly 26 deaths per 100,000 live births according to UNFPA estimates.
Conditions on the frontlines reveal high-risk birth trends, including a cesarean section rate exceeding 46 percent—well above the World Health Organization’s recommended ceiling of 15 percent—and premature births occurring at twice the national average. These figures underscore the compounded challenges of pregnancy during wartime: displacement, bombardment, and shortages of essential medicines and staff.
The Kharkiv Regional Perinatal Centre has also developed its own underground ward to maintain services amid power outages and infrastructure damage. Health workers report improvising in makeshift locations like basements and repurposed shelters to continue offering care. The strain on Ukraine’s healthcare system is intensified by a declining birth rate and population loss exceeding 10 million since 2014, as documented by UNICEF and UNFPA.
Looking ahead, UNFPA plans to seek substantial funding to sustain maternal health and protection efforts across Ukraine into 2026. Until then, these fortified maternity wards represent a vital adaptation, prioritizing safety and access to care for mothers and newborns in one of the world’s most challenging conflict zones.