Ukrainian women give birth in shelters and cellars. “Under these cruel conditions, the fullness of femininity is created”

The drama of Ukrainians continues. Not everyone is able to get out of a war-torn country. Among them are women who are expecting a baby. According to UN data, there are as many as 265 of them in Ukraine. One in three is in the third trimester of pregnancy. This means that the delivery will most likely find them in a shelter or a basement, where babies are already being born every day. We talk to Lucyna Mirzyńska, a family midwife with over 30 years of experience, about how childbirth looks like in these primitive conditions and the cruel reality of war and what makes women – after all – able to cope with this challenge.

1. In a situation as extreme as war, defense mechanisms are triggered during childbirth, allowing the woman to displace her sense of danger for the time of delivery
2. Hormones also play a huge role, especially adrenaline, called the fight hormone, and oxytocin – the hormone of happiness and love.
3. A woman’s body knows what to do. Our bodies are made to give birth. Of course, they are definitely not made to give birth in extremely harsh conditions, but having no alternative, they do what they can to survive. At this time, the organism behaves almost zoonotic – says an experienced midwife
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Paulina Wójtowicz, MedTvoiLokony: For most women, the birth of a child is the most beautiful moment in their lives, and they prepare for it for months. They make sure that they have a loved one next to them, that the conditions of childbirth are as comfortable and intimate as possible, that they feel safe and cared for. The war took all this from the Ukrainian women in a cruel way. Are we even able to imagine what the pregnant women feel when they have to give birth in cold shelters and cellars?

Lucyna Mirzyńska, midwife: We are not and may we never have to imagine it. Everything we can say about these births is based solely on the knowledge of the physiology of labor and the defense mechanisms that go into action in an emergency. Hormones also play a huge role here.

Like adrenaline?

Yes, but not only that. Our mind is very wise, it can throw out or retain the appropriate hormones so that something does not happen or, on the contrary, does happen. For example, adrenaline, also known as the stress hormone, is produced in a situation of danger or insecurity, but it is also a fight hormone. A woman who is already in labor will under its influence fight for the best for her and her baby.

The problem is that you can’t stay in combat mode for long. The body will seek rest.

There cannot be too much adrenaline, if only because it can inhibit contractions in the first stage of labor. It happens that when a woman comes to the hospital, her contractions soften. And what will it be like in times of danger? Will at least a little bit of intimacy offered by a screen, support of another woman, and soothing of emotions, allow me to enter the zone of relaxation and rest, help restore contractions, let other hormones work? I believe so. A woman’s body knows what it is doing, it knows how to give birth.

The highest level of adrenaline occurs before the second stage of labor and during it, because then its power is needed in action, and after delivery, we silence it a little with body contact, when mom cuddles her baby in the most natural way that will bring relief to both of them. The stress then leaves both the mother and the baby. Oxytocin is produced, known as the love hormone, which, by contracting early in labor, enables the baby to be born and gives both of them a sense of security. It also helps to stimulate lactation and produce endorphins.

Can the stress accompanying childbirth in such difficult conditions have a negative impact on the baby?

Of course, maybe, although this issue can also be extended to other births that are simply under great stress. These children are usually born with slightly more muscle tone, with problems in the first period of life. Adaptive phenomena, i.e. the time when a child learns to live outside the mother’s body, may be more difficult for him, and may take longer. Certainly, these children compensate for their stress by being close to their mother. And may these mothers give their children this closeness, for example through body contact, hugging, breastfeeding.

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The rest of the material for the video.

We are talking about time after delivery, but the baby must be born first. Not every Ukrainian woman will be able to reach a hospital or any place where she receives medical support.

We are used to the fact that there must be a professional in childbirth: a midwife, doctor, a person who has education and competence. But what you really need to give birth is a woman, a woman’s body. Other people are only supposed to support her in giving birth. Of course, if you manage to have at least one person next to you, not necessarily a medic, who will give you a sense of security, that’s good, but even without it, the birth will take place.

Nature will do its job?

Exactly. A woman’s body knows what to do. Our bodies are made to give birth. Of course, they are definitely not made to give birth in extremely harsh conditions, but having no alternative, they do what they can to survive. At this time, the organism behaves almost zoonotic. These are instinctive actions that are pushed by the old cerebral cortex – the same that accompanies us in very primal situations, such as childbirth. Thanks to this, a woman is able to give birth to a child even without the help of others and in places that seem neither safe nor friendly.

The term “shelter” takes on a new meaning.

Lucyna Mirzyńska

French surgeon and gynecologist Michel Odent once said that in order to change the world, we must first change the conditions in which children are born. Only for us the world has changed first, and it is a cruel one, to which children come in places such as shelters, basements or hospital basements. Are these places safe for them and their mothers? It is a paradox, but in the world in which they live now, these are places that their body – I hope it is – recognizes as safe. In the cruelty that surrounds them, the descent to the shelters will be the area that the body will recognize as “here I can do it”. But I stress: it shouldn’t be like this. No woman should give birth in the cold, with terrible background noises that can be heard even in these basements or the subway. She should give birth in warmth, silence and with sounds pleasant to her.

Reporters present in Ukraine report on the primitive conditions in which pregnant and later obstetricians with newborns live. Women give birth separated from other patients and staff only by a screen. There are sudden births, in shelters full of strangers. It has nothing to do with the intimacy that seems essential at a moment like this.

When the labor is advanced, i.e. when the woman is in labor, wave after wave comes, and she feels that she is being born from her, that the baby is flowing out, receiving no external stimuli. It is impossible to talk to her, she will not logically answer the questions, there is no chance that she would want to participate in the conversation at all. A woman closes herself in a kind of cocoon, enters the world of giving birth. At such a moment, nothing else matters to her but to give birth. This screen, although it seems nothing special, is a physically designated place for her, where she can vent her emotions, her psyche, surrender to the wave of contractions, and gives her space to give birth. In these cruel conditions, the fullness of femininity is created in the most instinctive way. Our body in a state of emergency is able to come up with a different story, not to see what is happening right next to it.

It sounds almost metaphysical, but after all, postpartum comes – a very difficult time for both mother and baby. The need for sleep, rest, regeneration, but also – proper hygiene, which in primitive conditions is a huge challenge.

This is what I fear the most. Hygienic conditions are not conducive to taking care of the physiological aspects of puerperium. I hope that in many cases it is possible to avoid incision of the perineum, which is one of the most common medical procedures used during childbirth also in Poland, and can be quite problematic in these circumstances. Thanks to this, the healing of the perineum will be easier, faster and natural. Luckily, a woman’s body is designed to heal quickly as long as it hasn’t been damaged externally.

We know that Ukrainian doctors have a huge problem with access to basic hygiene products. How to keep women and children safe without them?

A group of Polish midwives prepare and send them delivery packages. Normally, each hospital has several such packages available. Tools are cleaned, sterilized and reused. There is no chance for it here, so the packages include disposable, sterile kits.

What does or should such a package contain?

Contrary to appearances, you don’t need much to give birth. Just enough to ensure a minimum of cleanliness. A sterile compress, sterile gauze, a diaper or gauze to dry the child, a clamp to tighten the umbilical cord, scissors to cut the stump, a suction bulb in case the child’s airways need to be unblocked. Possibly a crotch kit, because some abrasions always happen. A obstetric earpiece may also be useful to listen to the child’s heartbeat, because we will not do CTG there. That’s all. The rest are the things that a woman usually prepares for the birth of a child: nappies, blanket, jacket, hat.

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There are voices that women who are currently giving birth in Ukraine are traumatized and that these births are a trauma. Is there a chance that the joy we experience when a new life comes into the world will cover it and overcome it?

War itself is a trauma, needless to say more. Is it more traumatic that a woman gives birth during the war? But by what scale to define it? Having a baby in any situation is beautiful. Beautiful and difficult at the same time. It is also difficult in the context of consciousness, or rather unawareness, what to do next. After all, no one knows when the war will end. And here I would probably see the greatest difficulty for these women: what next? Will the child’s father come home from the war? Will we get out of this shelter? Will I be able to provide my child with a roof over his head, clothes? These are questions that neither they nor anyone else knows the answer to.

Is there any consolation in all of this?

The fact that a child is born out of love, and even if not, is the source of it. And love always overcomes trauma, it allows you to take your mind off what’s next. It gives hope.

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