Babies born in bomb shelters as Ukraine population plummets

• Ukraine population shrinks as war takes toll
• Birth rate now one of the lowest in world
• Some see giving birth as act of defiance, sign of hope

KYIV - Deep beneath Kyiv, midwives are busy in a bomb shelter-turned-labour ward, where flickering lights cut through the dark to cast long shadows along its cold, concrete halls.

It's here, far below the sounds and scars of war, that new lives begin - but births are few and far between as Ukraine's population plummets after more than three years of conflict and the mass exodus that Russia's invasion triggered.

As war drags on without relent, Ukraine faces a quieter - if more existential - crisis: demographic collapse.

Since the war began in 2022, the population has shrunk by more than 10 million, or around a quarter.

The country now has one of the world's lowest birth rates and one of the highest death rates - 18.6 deaths per 1,000 people, according to the U.S. Central Intelligence Agency.

The birth rate has simultaneously fallen to about 0.9 children per woman, down from 1.16 before 2022, according to a government official.

The United Nations says that is one of the world's lowest - and experts say action is vital now to head off future fallout.

Hundreds of thousands of people of reproductive age have been killed or wounded and millions more have fled — many with no plans to return.

"The demographic situation is really dark," said Olga Oleinikova, a Ukrainian-born associate professor at the University of Technology Sydney.

She said that unless Ukraine reforms its crumbling healthcare system and addresses the trauma caused by war, the death toll will keep climbing - and long after conflict ends.

"Every day, we lose a lot of men. Our healthcare system for veterans definitely needs to be done now. It's fragmented. We need to focus on saving lives and making a healthy society, but it will take decades to get back to normal and millions of dollars," she said.

In the bunker-turned-ward, Alla Lobas, head midwife of Kyiv City Clinical Hospital, works at a place where hope meets fear.

"When the women hear explosions and you see the patient who is about to give birth, tears are just streaming down their face. The mothers are trembling, but when they feel the baby on their chest, it brings a little calm. They feel they must protect their child, and things shift."

"The future of Ukraine lies here," she said.

Millions flee

Liliya Ozel is part of that future but her story highlights the difficulties facing Ukrainians who want children.

In May, she was preparing to give birth at the Kyiv City Maternity Ward, having left her husband and two daughters, aged 4 and 7, in Turkey where they fled at the start of the war.

"When I found out I was pregnant, I wanted to come back here just to give birth," she said, acknowledging the many obstacles to rebuilding family life in Ukraine.

"My daughter struggled emotionally - the sirens, the alerts. She still wets the bed sometimes."    

"We want to return but if the war continues and it's not safe, we'll have to stay where it is safe for the children."

Ozel's husband was allowed to leave because he has Turkish citizenship, but under martial law, Ukrainian men aged from 18 to 60 are banned from going abroad without special permission.

Daniil Horobchenko is among them.

He married Dasha weeks after the invasion in a wedding celebrated under sirens and blackouts.

Today their dream of raising a child is unthinkable.

"One of the crucial moments was the electricity blackouts. We saw the hospitals with many pregnant women being shelled," Dasha said. "They also bomb the schools and then all the places where kids can be, even playgrounds."

Mothers turn defenders

Some mothers take another route.

Deep in the forests of Bucha, northwest of Kyiv, a group of women stand behind mounted machine guns, eyes fixed on the sky in search of enemy drones.

Among them is Kuma, who used a pseudonym due to safety concerns. The mother of two once lectured in economics but has now joined the ‘Women of Bucha’ - civilians turned defenders.

"I have two small children, aged 10 and nine. They must be protected. Every time I send them to school, I have to be sure that a drone won't come and crash on them," she said.

Countless mothers are now sole parents; fathers killed in battle, missing or on the frontlines.

The U.S. Center for Strategic and International Studies estimates 60,000-100,000 Ukrainian soldiers have been killed.

Average life expectancy has plunged from 66.4 years to 57.3 for men, and 76.2 to 70.9 for women, driven by trauma, alcohol abuse and collapsing healthcare, government figures show. 

The children who survive

War will haunt children into adulthood without speedy intervention now, said Kyiv-based psychologist Aksana Piseva.

"These kids, these teenagers, they were 15 when the war started, now they're 18  ... If we don't give them the tools to survive and heal now, the trauma will shape everything they do."

Olena Rozvadovska, co-founder of the Voices of Children Foundation which delivers psychological aid to children in war zones, said all Ukraine's children had been affected.

"Some children now believe war is all they'll ever know."

Yet in an act of hope and defiance, Rozvadovska is now pregnant with her first child.

"Life and death go together every day here. You can die any day and at any time and it makes you think - what's really meaningful in life? Your loved ones," she said.

"We don't want to lose our country. We  have to fight for our next generation with everything we can. So let’s have a baby."

(Reporting by Danielle Robertson; Additional reporting by Brianna Piazza, Yuri Stepanov and Bogdan Timura; Editing by Lyndsay Griffiths and Clar Ni Chonghaile)