Social Europe

  • EU Forward Project
  • YouTube
  • Podcast
  • Books
  • Newsletter
  • Membership

War and Ukraine’s sexual and reproductive health

Lucy Martirosyan 17th May 2023

Russia’s invasion has affected women in many ways, from pregnancy care to sexual violence as a weapon of war.

Warning: this article includes mentions of rape and sexual torture

In order to continue providing maternity care during air raids and bombings, medical staff at the regional maternity hospital in Poltava, central Ukraine, built a fully functioning operating theatre in the basement, in a matter of weeks, after the start of Russia’s invasion of Ukraine. It has been invaluable: many babies have been delivered there and major surgeries successfully carried out.

It is also one of the health clinics fully equipped with a gynaecological suite provided by the International Planned Parenthood Foundation (IPPF) via its Ukraine partner organisation, the Woman Health and Family Planning Charity Foundation (WHFP).

According to IPPF, the sexual- and reproductive-health impacts, immediate and long-term, of Russia’s invasion of Ukraine are numerous and widespread. They include an increase in sexual violence (mainly against women but also some men) and a rise in demand for abortions.

Under immense strain

Birth rates were worryingly low before the war but are now decreasing further: between January and November 2022, 195,000 babies were delivered in the country, a 30 per cent decrease on the previous year. There are also concerns about what happens after the war, the likelihood of a repopulation push and what that will mean for women’s choices. All this at a time when healthcare services across the country are depleted and under immense strain, with Russia’s invasion having led to a lack of facilities, personnel and equipment.

To help with the country’s most urgent sexual- and reproductive-health needs, WHFP has been providing hospitals and healthcare clinics with medication and equipment, including emergency obstetric kits, emergency contraception and pills for medical abortions. ‘[Ukrainian doctors] have been delivering babies in the metro because [of the bombings],’ said the WHFP executive director, Galyna Maistruk, an obstetrician-gynaecologist based in Kyiv.

‘If you speak to women about what we need—we need victory. We need Russia to leave our territory and to stop bombing us.’ But in the meantime, she said, ‘we’re trying to minimise the losses.’

Maistruk emphasised the importance of providing psychological—as well as medical—care for those traumatised by the war, adding that most pregnant women worried about how stress and panic could affect their pregnancies. The charity, which also operates in Kyiv, Kirovohrad, Odesa and Vinnytsia, trains medical professionals in being trauma-informed when speaking with women, especially survivors of rape.

‘No certain end point’

Nadiia*, who lives in a village near Poltava, decided to have an abortion in April after discovering she was pregnant unexpectedly. Her husband is earning less because of the war, they already have two children—she is still on maternity leave for her youngest—and she is caring for two elderly relatives who escaped from Russian-occupied territory.

‘My husband and I agreed that if the war wasn’t happening, we would have this baby. But to give something to our unborn child, we would have to take something away from our two children,’ Nadiia said. ‘Normally, we would have been able to cope—but there is no certain end point to this war.’

A local doctor recommended that she have the termination at the Poltava regional maternity hospital, specifically the WHFP suite. She went to the hospital, where she was consulted, counselled, checked via ultrasound and then asked if she was confident with her decision. She had the abortion and said she was pleased with the medical care she received.

The displacement of millions of Ukrainians since the Russian invasion has disproportionately affected women and children—they make up 90 per cent of the eight million Ukrainian refugees in Europe. But although the war is still raging, many people have returned home—either from abroad or after being internally displaced.

Tamara Zaiva is one of them. She fled to Poland with her husband and six-year-old son soon after the invasion last year. They remained for six months but, once she became pregnant, they decided to return to their home village of Dobroslav, an hour’s drive from Odesa.

‘There were some nuances with the health system in Poland that I couldn’t navigate,’ Zaiva, who is due to give birth by the end of May, said. These included language and financial barriers. ‘I wanted to come back to Ukraine to see my own doctor, who I can rely on and understand.’

Maistruk hopes that more women who have left Ukraine will return, but for this to happen there needs to be high-quality reproductive and sexual healthcare. ‘People need good services. This is a big attraction, even for people who left Ukraine as refugees,’ she said.

Sexual violence as tactic

From the start of the war, there have been many reports of sexual violence by Russian troops in Ukraine. Iryna Didenko, from the Ukrainian prosecutor’s general office, said in January: ‘Russian invaders have a clear pattern of behaviour when seizing territory. Ground forces arrive and rapes start on the second or third day.’ This was echoed by Nerida Williams, IPPF’s senior humanitarian communications adviser: ‘Russia is using sexual violence as a tactic of war.’

Ukrainian investigators have recorded widespread sexual abuse by Russian troops, with victims ranging in age from four to 82. According to Radio Free Europe, documented cases skyrocketed last year after parts of the Kharkiv region were liberated in September and the city of Kherson was liberated in November.

There is an information blackout however about Russian-occupied regions, such as the so-called ‘people’s republics’ of Donetsk and Luhansk in eastern Ukraine. ‘These people are under occupation by a terrorist state, which means all kinds of criminal things go on,’ said Maistruk.

Cases of intimate-partner violence against women have also escalated in Ukraine since the start of the invasion. ‘The curfew imposed by the war means that people aren’t outside at night, but rather stuck inside with people they know,’ said Anzhelika Yatsenko, one of the leading clinical psychologists in Poltava and a medical trainer for WHFP. ‘The stress and pressure of the war have a direct impact on the increase of sexual and gender-based violence rates.’

Men have also suffered from sexual violence, with reports of Russian soldiers castrating captured Ukrainian troops. Yatsenko has treated two male patients who were castrated by the Russian army while they were prisoners of war. ‘These cases have really touched me,’ she said. ‘These soldiers do not want pity but are in severe need of psychological care.’

Holding Russia to account

The prosecutor general’s office has interviewed hundreds of survivors of sexual violence. But by early March this year, only 155 had agreed to testify in court. Maistruk believes that if Russia is to be held accountable, earning the trust of survivors is crucial so that they will report the crimes committed against them to the International Criminal Court (ICC).

The ICC held a training session in Kyiv in March, on witness protection and support for victims of conflict-related sexual violence in Ukraine. Maistruk said: ‘It’s extremely important to [preserve] the memory of the victims … so we’re grateful for help from international investigators who know international law.’

* Names have been changed. This first appeared on openDemocracy

Lucy Martirosyan
Lucy Martirosyan

Based in Yerevan, Armenia, Lucy Martirosyan is openDemocracy’s Eurasia investigative reporting fellow, with a focus on Russia and post-Soviet states, having previously worked as a radio producer for the US-based The World.

Harvard University Press Advertisement

Social Europe Ad - Promoting European social policies

We need your help.

Support Social Europe for less than €5 per month and help keep our content freely accessible to everyone. Your support empowers independent publishing and drives the conversations that matter. Thank you very much!

Social Europe Membership

Click here to become a member

Most Recent Articles

u4219834664e04a 8a1e 4ee0 a6f9 bbc30a79d0b1 2 Closing the Chasm: Central and Eastern Europe’s Continued Minimum Wage ClimbCarlos Vacas-Soriano and Christine Aumayr-Pintar
u421983467f bb39 37d5862ca0d5 0 Ending Britain’s “Brief Encounter” with BrexitStefan Stern
u421983485 2 The Future of American Soft PowerJoseph S. Nye
u4219834676d582029 038f 486a 8c2b fe32db91c9b0 2 Trump Can’t Kill the Boom: Why the US Economy Will Roar Despite HimNouriel Roubini
u42198346fb0de2b847 0 How the Billionaire Boom Is Fueling Inequality—and Threatening DemocracyFernanda Balata and Sebastian Mang

Most Popular Articles

startupsgovernment e1744799195663 Governments Are Not StartupsMariana Mazzucato
u421986cbef 2549 4e0c b6c4 b5bb01362b52 0 American SuicideJoschka Fischer
u42198346769d6584 1580 41fe 8c7d 3b9398aa5ec5 1 Why Trump Keeps Winning: The Truth No One AdmitsBo Rothstein
u421983467 a350a084 b098 4970 9834 739dc11b73a5 1 America Is About to Become the Next BrexitJ Bradford DeLong
u4219834676ba1b3a2 b4e1 4c79 960b 6770c60533fa 1 The End of the ‘West’ and Europe’s FutureGuillaume Duval
u421983462e c2ec 4dd2 90a4 b9cfb6856465 1 The Transatlantic Alliance Is Dying—What Comes Next for Europe?Frank Hoffer
u421983467 2a24 4c75 9482 03c99ea44770 3 Trump’s Trade War Tears North America Apart – Could Canada and Mexico Turn to Europe?Malcolm Fairbrother
u4219834676e2a479 85e9 435a bf3f 59c90bfe6225 3 Why Good Business Leaders Tune Out the Trump Noise and Stay FocusedStefan Stern
u42198346 4ba7 b898 27a9d72779f7 1 Confronting the Pandemic’s Toxic Political LegacyJan-Werner Müller
u4219834676574c9 df78 4d38 939b 929d7aea0c20 2 The End of Progess? The Dire Consequences of Trump’s ReturnJoseph Stiglitz

KU Leuven advertisement

The Politics of Unpaid Work

This new book published by Oxford University Press presents the findings of the multiannual ERC research project “Researching Precariousness Across the Paid/Unpaid Work Continuum”,
led by Valeria Pulignano (KU Leuven), which are very important for the prospects of a more equal Europe.

Unpaid labour is no longer limited to the home or volunteer work. It infiltrates paid jobs, eroding rights and deepening inequality. From freelancers’ extra hours to care workers’ unpaid duties, it sustains precarity and fuels inequity. This book exposes the hidden forces behind unpaid labour and calls for systemic change to confront this pressing issue.

DOWNLOAD HERE FOR FREE

ETUI advertisement

HESA Magazine Cover

What kind of impact is artificial intelligence (AI) having, or likely to have, on the way we work and the conditions we work under? Discover the latest issue of HesaMag, the ETUI’s health and safety magazine, which considers this question from many angles.

DOWNLOAD HERE

Eurofound advertisement

Ageing workforce
How are minimum wage levels changing in Europe?

In a new Eurofound Talks podcast episode, host Mary McCaughey speaks with Eurofound expert Carlos Vacas Soriano about recent changes to minimum wages in Europe and their implications.

Listeners can delve into the intricacies of Europe's minimum wage dynamics and the driving factors behind these shifts. The conversation also highlights the broader effects of minimum wage changes on income inequality and gender equality.

Listen to the episode for free. Also make sure to subscribe to Eurofound Talks so you don’t miss an episode!

LISTEN NOW

Foundation for European Progressive Studies Advertisement

Spring Issues

The Spring issue of The Progressive Post is out!


Since President Trump’s inauguration, the US – hitherto the cornerstone of Western security – is destabilising the world order it helped to build. The US security umbrella is apparently closing on Europe, Ukraine finds itself less and less protected, and the traditional defender of free trade is now shutting the door to foreign goods, sending stock markets on a rollercoaster. How will the European Union respond to this dramatic landscape change? .


Among this issue’s highlights, we discuss European defence strategies, assess how the US president's recent announcements will impact international trade and explore the risks  and opportunities that algorithms pose for workers.


READ THE MAGAZINE

Hans Böckler Stiftung Advertisement

WSI Report

WSI Minimum Wage Report 2025

The trend towards significant nominal minimum wage increases is continuing this year. In view of falling inflation rates, this translates into a sizeable increase in purchasing power for minimum wage earners in most European countries. The background to this is the implementation of the European Minimum Wage Directive, which has led to a reorientation of minimum wage policy in many countries and is thus boosting the dynamics of minimum wages. Most EU countries are now following the reference values for adequate minimum wages enshrined in the directive, which are 60% of the median wage or 50 % of the average wage. However, for Germany, a structural increase is still necessary to make progress towards an adequate minimum wage.

DOWNLOAD HERE

Social Europe

Our Mission

Team

Article Submission

Advertisements

Membership

Social Europe Archives

Themes Archive

Politics Archive

Economy Archive

Society Archive

Ecology Archive

Miscellaneous

RSS Feed

Legal Disclosure

Privacy Policy

Copyright

Social Europe ISSN 2628-7641