Maternal Health in War: UNFPA’s Faye Callaghan on Ukraine’s Frontline Birth Crisis
Author(s): Scott Douglas Jacobsen
Publication (Outlet/Website): The Good Men Project
Publication Date (yyyy/mm/dd): 2026/04/20
Faye Callaghan is a maternal health specialist and midwife working with the United Nations Population Fund (UNFPA) in Ukraine. With expertise in reproductive health in humanitarian and conflict settings, she focuses on ensuring safe childbirth under extreme conditions, including the development of bunkerized maternity facilities. Her work addresses maternal mortality, emergency obstetric care, and psychosocial support systems amid war-related disruptions. Callaghan collaborates with international donors, health systems, and local providers to sustain critical services. She contributes to policy and field-level responses to gender-based violence and conflict-related sexual trauma while advancing resilient, adaptive healthcare delivery models in crisis environments.
Scott Douglas Jacobsen explores the realities of maternal healthcare in wartime Ukraine, highlighting stress, resilience, and systemic strain. Callaghan explains that maternity care lacks routine, requiring constant vigilance, especially under bombardment conditions. She emphasizes the importance of bunkerized facilities for safety and describes how prolonged stress can impair clinical judgment, increasing risks such as hemorrhage or missed complications. Rising maternal mortality is linked to delayed access to care and overwhelmed systems. The discussion also addresses gender-based violence, psychosocial gaps for healthcare workers, and long-term developmental impacts on children born under stress, underscoring the human limits behind narratives of “super resilience.”
Scott Douglas Jacobsen: I was speaking with professionals working with veterans in mental health rehabilitation. Some of the veterans asked whether a full recovery is possible. The general response was that, while it may happen in some cases, most do not fully return to who they were before. Instead, the more realistic outcome is integration—acknowledging their experiences and building a new life around them.
I also spoke with a career counsellor who noted that many veterans do not want to return to their previous professions. They want a new direction entirely. That suggests a desire for a complete reset.
There is also a broader narrative about resilience. We often hear about “superwomen” and “super caretakers” among frontline workers and mothers taking on additional responsibilities. That is clearly grounded in reality, given the level of pressure they are under. At the same time, there is another equally important truth: they are human beings under sustained strain.
In many cases, those who remain are the ones able to endure these conditions. Can you walk me through what their daily, weekly, or monthly responsibilities look like when they are living on site for weeks at a time? You are likely in contact with some of them.
Faye Callaghan: In a maternity ward, there is effectively no routine because birth is unpredictable. Staff must remain constantly alert and ready for any situation. It is not a relaxing environment.
Unlike some workplaces, a maternity hospital does not provide an escape from external pressures. You do not know how many women will arrive or what conditions they will present with. The role of a midwife is to make the experience as safe and positive as possible, to reassure the woman, and to be prepared to carry out emergency interventions when needed.
That is where bunkerized facilities are especially important. They help create a sense of safety. In some cases, we have adapted existing underground shelters into maternity wards. Some of these were originally designed to withstand extreme scenarios, so they provide strong physical protection. If that environment can be made calm enough for a woman to feel safe delivering her child, that is a significant achievement.
Jacobsen: Are there psychosocial supports or mental health services available for these healthcare workers?
Callaghan: UNFPA primarily provides psychosocial support to survivors of gender-based violence. That is our main focus. Additional support for healthcare workers is an area where broader systems and partnerships are important, and there is a clear need.
Jacobsen: How long are their workdays?
Callaghan: A typical shift is around 12 hours, either day or night. However, in current conditions, routines often break down. Some staff remain on site for days at a time.
Jacobsen: What happens when stress becomes overwhelming?
Callaghan: Stress can narrow focus. In maternity care, which is already a high-pressure environment, this can mean concentrating intensely on one issue while missing another critical development.
For example, a provider may focus on a newborn with breathing difficulties while not immediately recognizing that the mother is experiencing severe hemorrhage, which is also life-threatening. Under stress, it becomes much harder to track multiple risks simultaneously.
That is why teamwork and adequate staffing are essential. Ideally, one provider monitors the newborn while another monitors the mother. It is not possible for one person to safely manage both in a high-risk situation, especially under stress.
Jacobsen: Does that level of stress contribute to increased complications or mortality among mothers?
Callaghan: Ukraine has made significant progress in reducing maternal mortality over the past two decades. However, more recent data indicate an increase in maternal mortality between 2024 and 2025.
There are multiple contributing factors. These may include delays in accessing care, increased strain on the healthcare system, and challenging working conditions. We are seeing increases in complications such as hemorrhage.
Another major factor is uterine rupture, which is a life-threatening condition. It is often associated with delayed access to appropriate care or complications during labour.
You can imagine the situation in a frontline environment. Bombardments are ongoing, and a woman goes into labour. She must decide whether to remain at home, where she feels safer, or attempt to travel through potentially dangerous conditions to reach a maternity hospital. Many may choose to stay at home.
If a serious complication occurs, such as uterine rupture, there is very limited time to respond. In such cases, urgent medical intervention is required within minutes to save the lives of both the woman and the baby. If access to care is delayed or impossible, the consequences can be fatal. That is one of the real impacts of attacks affecting healthcare access.
Jacobsen: Are statistics on injuries, deaths, and related outcomes publicly available?
Callaghan: Some data are publicly available. We can share a public health situation assessment published last year, which includes statistics for 2024 and 2025. We can also provide a more specific assessment focused on sexual and reproductive health.
Jacobsen: I am aware that the Russian Federation has changed its domestic violence legislation. I am also aware that there are significant frozen Russian assets internationally. Given that this is a humanitarian issue, involving gender-based violence, maternal health, and future generations, and that UNFPA is an authoritative UN body, could the use of those assets be considered for these needs?
Callaghan: I cannot comment on the use of Russian assets. We rely on donor support, and we are very grateful for that. For example, Ireland recently announced an additional €4 million in funding, which may support the expansion of bunkerized maternity units and outreach services to communities.
Jacobsen: Who are the largest supporters at present, beyond Ireland?
Callaghan: The European Union is a major supporter. For other contributors, we need to confirm the details.
Jacobsen: Turning to gender-based violence, it is a broad category. Even in highly developed countries with strong gender equality frameworks, such as Iceland, definitions of violence have expanded to include financial and emotional abuse, not only physical violence or visible injury. Sexual violence is also a major component. How is gender-based violence being documented and categorized in this context?
Callaghan: I am not a gender-based violence specialist, but we can connect you with someone who is. What I can say is that we have seen an increase in gender-based violence in Ukraine since the start of the full-scale war. UNFPA is working extensively on this issue, including at the policy level with the government, to support responses that align with international standards for assisting survivors of sexual violence. That includes access to medical care, psychological support, and broader social services.
Another major issue is conflict-related sexual violence, which Ukraine, like many countries, has not had to address at this scale in recent decades. There is a clear need to develop specialized support systems for survivors, given the complexity of their needs.
At present, UNFPA is also working on rehabilitation approaches at the family level, including support for individuals—such as soldiers or former prisoners of war—who return with these experiences.
Jacobsen: Yes, I have seen recent reporting from UN bodies on that issue. One final question for this session: In visiting veterans in recovery, many say they do not fully “get over” these experiences. Given the length of the war, infants born prematurely or under high-stress conditions may also face physiological impacts. They have no agency in these circumstances. How might that affect them over the course of their development?
Callaghan: It can, although it depends on the individual and the conditions they experience. There is another important factor: the relationship between the father and the child. If the father is absent for extended periods, there may be challenges in attachment and bonding when he returns. That can place additional stress on the mother and may have longer-term social and developmental implications for the child.
Jacobsen: One final point. There is a narrative about “superwomen” and “super caretakers” among frontline workers and mothers who take on additional responsibilities. That is clearly grounded in reality, given the level of pressure they are under. At the same time, there is another equally valid perspective: they are human beings under sustained strain. In many cases, those who remain are the ones able to endure these conditions.
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