As Ukraine’s delivery fee plunges, here is what one physician is doing to reverse the pattern

LVIV, Ukraine — As an OB-GYN physician, Stefan Khmil has constructed a virtually 50-year profession on serving to girls in Ukraine have youngsters — an particularly vital job in Ukraine, the nation with the bottom delivery fee in all of Europe.

Nevertheless, the final 2 1/2 years have been a selected problem, as Russia’s full-scale invasion has upended every little thing.

Khmil says not solely have docs and sufferers been displaced due to the combating, the battle has additionally put the basic constructing blocks to make life in danger.

“Many of [the doctors] evacuated with sperm, eggs and equipment,” Khmil, 68, tells NPR. “So we helped them … to save it and not to lose everything.”

He introduced a few of these cryogenically frozen specimens to his two clinics in western Ukraine — one within the metropolis of Ternopil and one in Lviv — so sufferers may proceed their child-conceiving remedies, similar to in vitro fertilization.

Quickly, Khmil began pondering past what had already been harvested.

“I started thinking about what we need to do to preserve the biological material from our military, so we started offering to freeze the spermatozoa of men serving in the military for free,” he says.

A combating probability

Dr. Khmil’s obstetrics clinic was the primary of many throughout the nation to make the transfer, saving Ukrainians 1000’s of U.S. {dollars} on the process.

In March, President Volodymyr Zelenskyy signed a regulation permitting troopers to do exactly that — protect their reproductive cells free of charge.

Khmil says that the concern isn’t nearly demise in fight. Elements similar to stress, excessive climate and the usage of chemical compounds and ammunition on the battlefield can all have a detrimental impact on sperm — even render a person infertile.

“We can give these men who are fighting the opportunity to have children after the war, during war, whenever they want,” Khmil says.

His clinics additionally supply the harvesting and freezing of army girls’s eggs for free of charge. Since Russia’s full-scale invasion in February 2022, Khmil has helped over 400 households and over 60 youngsters be born.

Viktoriia Onyshchuk hopes to be a type of success tales.

The 34-year-old from the town of Kryvyi Rih, in central Ukraine, is a fight medic and drove hours from the entrance line to have her eggs harvested at Khmil’s Lviv clinic.

“I have been trying to have children since 2010,” she says.

Onyshchuk’s husband, Petro, who can be within the army, froze his sperm a while in the past. However it’s taken months for her to seek out time to get away to have the operation, as a result of lengthy rotations on the entrance.

In preparation for the surgical procedure, Onyshchuk has been taking highly effective hormone medicines. The capsules have triggered her bloating, cramping and fatigue — all compounded by her job. However since a girl’s physique usually solely produces one egg per menstrual cycle; for a profitable egg harvesting operation they should get between six and eight, she says.

However Onyshchuk doesn’t thoughts. She says it’s a girl’s responsibility to present delivery — particularly now.

“We don’t know what will happen to our country,” she says. “And when peacetime comes, somebody will have to rebuild it.”

Inhabitants woes predate struggle

As Ukrainians attempt to conceive of life after struggle, considerations about who can be round to hold Ukraine into the longer term hold over the nation like a pall.

However Ukraine’s demographic disaster far predates 2022. It truly started as quickly because the nation gained independence from the Soviet Union in 1991, when its inhabitants was estimated to be about 52 million.

At present, the United Nations says Ukraine’s inhabitants is a bit of below 38 million — a drop by virtually 1 / 4 in simply 30 years.

Tymofii Brik, the rector of Kyiv College of Economics, says the explanations are a “little bit of everything.” Even lengthy earlier than the Russian invasion, Ukrainian males had a few of the highest mortality charges in Europe, as a result of dangerous work and life, he says, solely residing to 65 years outdated, on common. Additionally, a lot of the inhabitants has merely left for higher, higher-paying work and a safer life with a much less aggressive neighbor.

Brik says, in the meantime, Ukraine can be experiencing the identical downturn in delivery fee as different fashionable, industrialized nations.

“When you have these kinds of societies, usually plans and ideas of your life also change,” he says. “In these societies, usually people do not plan to have a lot of kids.”

Ukraine’s Well being Ministry says the nation’s delivery fee has been dropping since 2013. In 2023, the ministry reviews, a mean of about 16,100 youngsters have been born each month. Earlier than the full-scale invasion, the quantity ranged from 21,000 to 23,000-per month.

Massimo Diana, the U.N. Inhabitants Fund consultant in Ukraine, says that the nation’s delivery charges have dropped beneath one youngster per lady. Demographers say that’s far decrease than “replacement level fertility” — which says the typical variety of youngsters born per lady must be about 2.1 to take care of the inhabitants stage. Any greater quantity would obtain inhabitants progress.

Russia’s full-scale invasion has displaced some 14 million Ukrainians with rather less than half nonetheless remaining outdoors of the nation, in accordance with the U.N. refugee company.

So when the struggle ends, Brik says, Ukraine must work laborious to make households really feel protected and safe sufficient to not solely have youngsters — however to have extra youngsters than earlier than.

Future Ukrainians

OBG-YN docs throughout Ukraine are there to assist the households who say they can’t look ahead to peace.

Svitlana Teleniuk and her husband, Bohdan Teleniuk, needed extra youngsters despite the fact that they already had two boys. However when the full-scale invasion began, he went off to struggle they usually by no means discovered the time.

“He was only home for a couple of days,” says Teleniuk, who’s 48 and from Ternopil.

In order that they turned to Dr. Khmil, who froze Bohdan’s sperm in January 2023. Twins Angelina and Artur have been born in February the next 12 months.

However these infants won’t ever meet their father, as Teleniuk came upon she was pregnant simply days after going to his funeral. Bohdan died on the entrance strains.

“The boy is an absolute copy of my husband, an identical copy,” she says, lovingly peering into Artur’s twinkling brown eyes, his chubby cheeks turning purple with smiles.

Like so many different Ukrainian girls, Teleniuk will elevate the twins and her older son by herself now. She says she’s proud and needs to do it herself.

Khmil acknowledges that life in Ukraine will possible not be simple for these moms and their youngsters born throughout struggle. However he sees his work — serving to households have youngsters — as a means of doing his half to avoid wasting his nation.

“Russia is destroying the Ukrainian nation and killing Ukrainian people — we have to respond,” he says.

Polina Lytvynova and Hanna Palamarenko contributed to this story from Lviv and Ternopil, Ukraine.