For Pregnant Women in Ukraine, A New Kind of Support

Mere days into the Ukraine war, they were already hearing reports of women giving birth in shelters, railway stations, and basements without a skilled attendant.

So Well Born – a Polish organization of midwives, doulas, psychologists, and lactation consultants that focuses on independent midwifery practice and out-of-hospital perinatal care – swung into action.

“Imagine you have nothing and you have a laboring woman…What would you need?” said Maria Romanowska, a midwife and co-coordinator of Well Born for Ukraine, a project designed to provide pregnant women in Ukraine and their attendants with the necessary tools for a safe, successful birth.

Members of the project designed a kit women could carry with them that contained the basic materials needed for a birth – such as instruments to cut and clamp the cord and blankets to keep the baby warm. Included were instructions intended for someone without any medical training that explained, in detail, what to expect and do. Materials on lactation were also included. “We did our best to write it in layman language, and then we had it translated into Ukrainian,” Romanowska explained.

The birth kits proved useful to organizations working in Ukraine. “Since the very, very beginning of the war, there has been feedback that those packages were very useful and very helpful,” said Romanowska, recalling pictures of pregnant women carrying the kits with them as they traveled. “It is very heartwarming and sad at the same time.”

The kits – over 800 of them – were primarily driven over the border into Ukraine by an informal network of volunteers. For example, “we received info about someone who has a pickup and he’s going to Kyiv twice a week,” Romanowska explained.

In a village of approximately 1,500 people in Ukraine’s Khmelnytsky district, a woman named Natasha works as a feldsher – a health worker designation similar to a physician assistant that is no longer awarded in Ukraine, although existing feldshers still practice. She described receiving birthing kits that she passed onto a regional hospital and a nonprofit group caring for pregnant women.

“Our day-to-day activities have barely changed. At the same time, we never have any certainty that the missiles won’t reach us. So we continue on with our work this way, but we have to be ready for anything,” Natasha said.

Even for individuals who couldn’t access the birth kits, the instructions on birth and lactation – written by Romanowska and fellow birthing professionals – proved invaluable. People began contacting Well Born for Ukraine over social media, asking for the instructions.

“The hospital is 10 minutes away [for some Ukrainians] but there is fire on the streets,” Romanowska said. “This is a strange, funny war: You are facing death in a shelter, but you are online.”

Often, she wasn’t able to send the kits themselves, but she could get pregnant women, their families, or those caring for them the instructions over the Internet.

As the war has changed, so too have the kits. Once it became clear that women were no longer in imminent danger of giving birth without a skilled attendant – and instead, that the need for appropriate supplies in hospital settings was acute – Well Born for Ukraine pivoted.

They began creating kits for health care providers with medical but no perinatal experience, then specialized kits for obstetricians and midwives working in hospitals.

The kits contain medical and surgical tools, but “it is handy, it is small, so it is supposed to be used in the hospital to have a regular hospital birth safely,” Romanowska said. “If the hospital in which you’re working is suddenly bombed, you can grab the package and you can grab the patient, and you can use it anywhere.”

In addition, the organization is providing requested equipment and supplies to Ukrainian hospitals, such as pulse oximeters, sutures, and bedding materials. “We send hospitals exactly what they ask us for, not what we think they might need,” she explained.

Well Born for Ukraine’s members plan to continue their work even after the war in Ukraine is over, as the need will continue to be great.

“We feel that our main goal in our work is elasticity,” Romanowska said. “We need to adjust to the situation, and the situation is changing basically every day.”

---

Direct Relief provided Well Born for Ukraine with a $140,000 grant to develop and assemble birth kits and distribute them in Ukraine. The organization is committed to providing support for Ukrainian women and pregnant people as the war continues.