The influence of war on pregnancy and childbirth in female service members and internally displaced women

Authors

DOI:

https://doi.org/10.14739/2310-1210.2026.2.338811

Keywords:

war, pregnancy, childbirth, female military serviceman, internally displaced person

Abstract

Aim: to synthesize existing scientific literature to evaluate the impact of war and military conflict on the course of pregnancy and childbirth among female service members and internally displaced women.

Materials and methods. We conducted a descriptive-comparative analysis focused on the reproductive outcomes of female service members and internally displaced women during wartime. The study was based on a systematic review and synthesis of current scientific literature to identify the primary factors through which hostilities influence maternal health. The research utilized methods of searching, comparative analysis, generalization, and synthesis of peer-reviewed data.

Results. The analysis indicates that women and children bear a disproportionate burden during armed conflicts. Most maternal and neonatal deaths in war zones are indirect, resulting from untreated diseases, malnutrition, pregnancy complications, and the collapse of healthcare infrastructure. Inadequate or absent antenatal care for internally displaced women is significantly associated with an increased risk of complications during pregnancy and delivery. This cohort exhibits higher rates of preterm birth and low birth weight, alongside an elevated risk of maternal mortality. Due to the destruction of medical facilities and shortages of personnel and essential medications, systemic obstetric assistance is often unavailable. Consequently, some women resort to unskilled birth attendants or remain entirely without medical support. Among Ukrainian female service members, the gynecological pathology profile is dominated by stress-induced disorders and pelvic inflammatory diseases. These conditions are often exacerbated by insufficient awareness regarding the prevention of sexually transmitted infections in field conditions.

Conclusions. Military conflict and displacement exert a profoundly negative influence on female reproductive health and obstetric outcomes. Given the increasing number of women in the military and the veteran population, it is crucial to address the unique reproductive health needs of this demographic to improve medical care and long-term quality of life. In combat zones, the rising rate of unassisted births significantly escalates the risk of maternal and neonatal mortality. Priority must be given to organizing specialized medical care in extreme conditions, focusing on systematic pregnancy monitoring, emergency obstetric care, and comprehensive postpartum support.

Author Biography

V. V. Babaian, State Institution “Ukrainian Center of Мaternity and Childhood of the National Academy of Medical Sciences of Ukraine”, Kyiv

MD, Junior Researcher at the Department of Prevention and Treatment of Purulent-Inflammatory Diseases in Obstetrics

References

Riquelme-Gallego B, Ramos-Soberbio L, Leno-Duran E, Martínez-Vázquez S, Caparros-Gonzalez RA. Adverse fetal and neonatal impact of war conflicts during pregnancy: A systematic review. IUBMB Life. 2025;77(2):e70006. doi: https://doi.org/10.1002/iub.70006

Krupelnytska L, Morozova-Larina O. Perinatal experiences of Ukrainian women at the beginning of the war. J Reprod Infant Psychol. 2025;43(2):532-49. doi: https://doi.org/10.1080/02646838.2023.2240827

Bouachba A, Gorincour G, Charlier P, Ville Y. Pregnancy in Times of War: What Are the Fallouts? A Review. Fetal Diagn Ther. 2024;51(6):559-70. doi: https://doi.org/10.1159/000540508

Arbuzova S, Nikolenko M, Atramentova L, Cuckle H. Evidence of reduced birthweight in Ukraine following the Russian invasion. Sci Rep. 2025;15(1):14413. doi: https://doi.org/10.1038/s41598-025-98668-8

Malachynska MY, Veresniuk NS. [The impact of warrelated stress on the autonomic nervous system of pregnant women: risk assessment and correction strategies]. Reproductive Endocrinology. 2025;(2):14-8. Ukrainian. doi: https://doi.org/10.18370/2309-4117.2025.77.14-18

Zahedroozegar MH, Shaygani F, Marzaleh MA. Pregnancy in Wartime: An Opportunity for Making Peace through Health. Iran J Public Health. 2023;52(11):2476-7. doi: https://doi.org/10.18502/ijph.v52i11.14048

Cabra-Bautista G, Granados Rugeles CM, Grillo-Ardila CF, Gil Laverde FA. Exposure to armed conflict as a factor associated with very low birth weight: Case-control population study. Int J Gynaecol Obstet. 2022;158(3):619-25. doi: https://doi.org/10.1002/ijgo.14082

Amsalu R, Firoz T, Lange IL, Tappis H. Editorial: Maternal Health in Conflict Settings. Front Glob Womens Health. 2022;3:807257. doi: https://doi.org/10.3389/fgwh.2022.807257

Rodríguez-Muñoz MF, Chrzan-Dętkoś M, Uka A, García-López HS, Krupelnytska L, Morozova-Larina O, et al. The impact of the war in Ukraine on the perinatal period: Perinatal mental health for refugee women (pmh-rw) protocol. Front Psychol. 2023;14:1152478. doi: https://doi.org/10.3389/fpsyg.2023.1152478

Amsel L, Cycowicz YM, Rodriguez-Moreno DV, Cheslack-Postava K, McReynolds LS, Musa GJ, et al. The Long-Term Physical-Psychiatric Comorbidities Related to Childhood Exposure to 9/11 Trauma. Int J Environ Res Public Health. 2024;21(8):988. doi: https://doi.org/10.3390/ijerph21080988

Spichak KO, Govsieiev DO. An analysis of perinatal outcomes in pregnant women with arterial hypertension in Poland and Ukraine during times of conflict. Ukrainian Journal of Perinatology and Pediatrics. 2023;(2):70-6. doi: https://doi.org/10.15574/PP.2023.94.70

Dirican AÖ, Korucu DG. A comprehensive evaluation of pregnancy and newborn outcomes in Syrian refugees in Turkey. BMC Pregnancy Childbirth. 2024 2;24(1):3. doi: https://doi.org/10.1186/s12884-023-06168-2

McCall SJ, El Khoury TC, Ghattas H, Elbassuoni S, Murtada MH, Jamaluddine Z, et al. Maternal and infant outcomes of Syrian and Palestinian refugees, Lebanese and migrant women giving birth in a tertiary public hospital in Lebanon: a secondary analysis of an obstetric database. BMJ Open. 2023;13(2):e064859. doi: https://doi.org/10.1136/bmjopen-2022-064859

Krupelnytska L, Vavilova A, Yatsenko N, Chrzan-Dętkoś M, Morozova-Larina O, Uka A, et al. War in Ukraine vs. Motherhood: Mental health self-perceptions of relocated pregnant women and new mothers. BMC Pregnancy Childbirth. 2025;25(1):253. doi: https://doi.org/10.1186/s12884-025-07346-0

Parisi F, Coco C, Cetin I; SIMPLE study group. Prospective multicentre Italian pregnancy cohort study (SIMPLE) on the associations of maternal first trimester SIMPLE nutritional score with early placental function markers and pregnancy outcomes. BMJ Open. 2022;12(10):e062940. doi: https://doi.org/10.1136/bmjopen-2022-062940

Zhang T, He Q, Richardson S, Tang K. Does armed conflict lead to lower prevalence of maternal health-seeking behaviours: theoretical and empirical research based on 55 683 women in armed conflict settings. BMJ Glob Health. 2023;8(8):e012023. doi: https://doi.org/10.1136/bmjgh-2023-012023

Punamäki RL, Diab SY, Vänskä M, AlBarqouni N, Quota SR. Maternal and foetal exposure to potentially toxic metals of modern weaponry and infant cognitive, sensorimotor, and socioemotional development: The role of breastfeeding. Infant Behav Dev. 2025;79:102040. doi: https://doi.org/10.1016/j.infbeh.2025.102040

Savona-Ventura C, Mahmood T, Mukhopadhyay S, Martins N, Louwen F, Tarlatzis B. The consequences of armed conflict on the health of women and newborn and sexual reproductive health – A position statement by the European Board and College of Obstetrics and Gynaecology (EBCOG). Eur J Obstet Gynecol Reprod Biol. 2022;274:80-2. doi: https://doi.org/10.1016/j.ejogrb.2022.05.015

Terkawi AS, Bakri B, Bakour C. Pregnancy and delivery characteristics and outcomes in Northwestern Syria: A prospective cohort study. Int J Gynaecol Obstet. 2023;163(1):256-64. doi: https://doi.org/10.1002/ijgo.14826

Jawad M, Hone T, Vamos EP, Cetorelli V, Millett C. Implications of armed conflict for maternal and child health: A regression analysis of data from 181 countries for 2000-2019. PLoS Med. 2021;18(9):e1003810. doi: https://doi.org/10.1371/journal.pmed.1003810

Bitan R, Magnezi R, Reuveni I, Tripto A, Weinstein O, Amikam U. Perinatal outcomes during wartime: a multicenter retrospective cohort study in Israel, 2022-2024. BMC Pregnancy Childbirth. 2025;25(1):1148. doi: https://doi.org/10.1186/s12884-025-08330-4

Siusiuka VH, Pavliuchenko MI, Shelestova LP. Socio-psychological aspects of the military aggression in Ukraine: a focal point on women’s reproductive health. Reprod Health Woman. 2025;(4):72-8. doi: https://doi.org/10.30841/2708-8731.4.2025.335427

Teka H, Ebrahim MM, Nardos R, Legesse AY, Berhe Y, Berhe H, et al. The impact of armed conflict on maternal morbidity and mortality at a teaching hospital in the Tigray region of Ethiopia: a pre-war and wartime comparative analysis. BMC Pregnancy Childbirth. 2025;25(1):389. doi: https://doi.org/10.1186/s12884-025-07505-3

Nguyen M, Le K. The impacts of armed conflicts on prenatal and delivery care utilization. J Appl Econ. 2022;25(1):819-38. doi: https://doi.org/10.1080/15140326.2022.2068178

Jordan NN, Gaydos JC, Garges EC. A Comparative Analysis of Reported Chlamydia and Gonorrhea Cases Among US Army Soldiers, 2015 to 2019. Sex Transm Dis. 2021;48(12):945-50. doi: https://doi.org/10.1097/OLQ.0000000000001481

Karasek L, Smetana J, Svobodova P, Smahelova J, Tachezy R, Kiss I, et al. Prevalence of sexually transmitted infections in women of the Czech Republic Armed Forces: a cross-sectional pilot study. BMJ Mil Health. 2025;171(3):207-12. doi: https://doi.org/10.1136/military-2023-002611

Lutgendorf MA, Tyagi R, Edwards S, Deering S, Raiciulescu S, Walton RB, et al. Posttraumatic Stress Disorder and Pregnancy Outcomes. O G Open. 2025;2(1):e060. doi: https://doi.org/10.1097/og9.0000000000000060

Basha S, Socarras A, Akhter MW, Hamze M, Albaik A, Hussein I, et al. Protracted armed conflict and maternal health: a scoping review of literature and a retrospective analysis of primary data from northwest Syria. BMJ Glob Health. 2022;7(8):e008001. doi: https://doi.org/10.1136/bmjgh-2021-008001

Aldabbour B, Elamassie S, Mahdi S, Abuzaid H, Abed T, Tannira Y, et al. Exploring maternal and neonatal health in a conflict-affected setting: cross-sectional findings from Gaza. Confl Health. 2025;19(1):45. doi: https://doi.org/10.1186/s13031-025-00687-9

Buitrago G, Moreno-Serra R. Conflict violence reduction and pregnancy outcomes: A regression discontinuity design in Colombia. PLoS Med. 2021;18(7):e1003684. doi: https://doi.org/10.1371/journal.pmed.1003684

Malachinska MI. [Problems of access to healthcare services in the armed conflict zones: Literature review]. Reproductive endocrinology. 2024;(3-4):8-13. Ukrainian. doi: https://doi.org/10.18370/2309-4117.2024.73.8-13

Baye K, Laillou A, Chitekwe S. Co-coverage of reproductive, maternal, newborn and child health interventions shows wide inequalities and is associated with child nutritional outcomes in Ethiopia (2005-2019). Matern Child Nutr. 2024;20 Suppl 5(Suppl 5):e13452. doi: https://doi.org/10.1111/mcn.13452

Additional Files

Published

2026-04-23

How to Cite

1.
Babaian VV. The influence of war on pregnancy and childbirth in female service members and internally displaced women. Zaporozhye Medical Journal [Internet]. 2026Apr.23 [cited 2026Apr.23];28(2):175-80. Available from: https://zmj.zsmu.edu.ua/article/view/338811