Reproductive Health Support Programme

The Reproductive Health Support Program is implemented by the UAEP team for Ukrainian women who have been displaced from Ukraine due to Russian military aggression. This is particularly crucial as 90% of the 6.28 million individuals (https://data.unhcr.org/en/situations/ukraine as of June 6, 2023) registered for temporary protection in Europe are women of childbearing age, pregnant, and/or mothers with children.

According to the United Nations Population Fund (UNFPA) and observations from the International Confederation of Midwives (ICM), refugee women are at an increased risk of sexual violence, unwanted pregnancies, sexually transmitted infections, malnutrition, poor sanitation conditions, and lack of maternal care.

On May 5, 2022, the European Parliament adopted the resolution "The impact of the war in Ukraine on women" (2022/2633(RSP)), which highlighted the lack of access to sexual and reproductive health services and rights for women in Ukraine and women refugees arriving in EU countries.

The resolution states:

Women should have access to a comprehensive range of sexual and reproductive health services, including emergency contraception, contraceptives, legal and safe abortions, antenatal care, and qualified delivery assistance. They require proper medical care, assistance in employment, adequate school education for children, and protection against gender-based and sexual violence.

We also recognize that forcibly displaced women who have been traumatized by Russian aggression experience the loss of familiar physical, psychological, and financial support. Leaving their home country is an additional powerful stress factor due to separation from loved ones, involuntary immigration, the need for adaptation in conditions of uncertainty, language and cultural barriers, and changes in social status.

We pay special attention to the most vulnerable among displaced women, namely pregnant women and mothers with young children. According to preliminary assessments by the International Confederation of Midwives (ICM), approximately 9% of forced immigrant women from Ukraine are pregnant. Evidence indicates a higher prevalence of preterm births, low birth weight, and stillbirths among those affected by military aggression and displaced persons. The significant stress and daily challenges, as well as the adaptation processes, directly impact these outcomes.

We cannot remain indifferent to the problem, which is only growing in scale, and we strive to minimize the consequences for the demography and health of the Ukrainian population. Intending to reduce the aforementioned and other complications during pregnancy, childbirth, and the postpartum period, we propose the implementation of a reproductive health support program in Ukraine and abroad, with a current focus on perinatal support.

The perinatal period encompasses three critical stages that significantly impact the health of the mother and the newborn, their vitality, and the realisation of their physical and mental potential. These stages include pregnancy and intrauterine development, childbirth and delivery, and the postpartum adaptation of the mother and the child.

The perinatal support program we propose for displaced women was developed in collaboration with physical therapists and obstetrician-gynaecologists. It was successfully implemented in the Obstetrics Department of DKLMI Mechnikov in Ukraine in the autumn of 2019 and transitioned to an online format during the 2020 lockdown. Adaptation of the program for displaced women in the UK took place in June 2023, incorporating necessary changes to address the specific needs of pregnant women and those giving birth abroad, considering sociocultural factors and the functioning of the local healthcare system in providing midwifery care.

The goals of the program were and remain the formation of a positive childbirth and motherhood experience, fostering informed attitudes toward the childbirth process, promoting healthy pregnancy, childbirth, and newborn care, and strengthening the family system. The implementation of the Support Program for pregnant women and women in early motherhood by Ukrainian professionals abroad also holds intercultural significance.

Preserving the health of displaced women and their children, improving their adaptation and supporting their integration process reduces the stress impact on the host country and significantly alleviates the financial burden on the healthcare and social systems. The existing program encompasses support for motherhood and parenthood at different stages, starting from preconception preparation and extending to the period of breastfeeding.

It addresses the following objectives:

1. Provision of informational, psychological, and physical support for pregnant women and mothers;

2. Conducting psycho-physical preparation for childbirth and motherhood;

3. Physical and psychological support during the postpartum period and early stages of motherhood;

4. Postpartum recovery and rehabilitation.

The program is implemented through various channels:

• Online platforms such as websites, social media pages and groups, YouTube channels, etc., for information dissemination and interaction between pregnant women and professionals.

• Social school of motherhood, providing online courses for childbirth preparation, breastfeeding, and newborn care.

• Practical sessions such as yoga, gymnastics, exercises, and practices specifically designed for pregnant women.

• Online and offline events for pregnant women, including resource-sharing sessions, therapeutic activities, thematic meetings, lectures, and webinars.

Within the framework of the Social School of Psychoemotional and Physical Preparation for Childbirth, a total of approximately 50 online lectures for pregnant women (100 hours) and about 200 hours of practical sessions have been conducted since the full-scale invasion began. The program has been implemented in the UK since June 2022, and a chat and information channel for the support of Ukrainian pregnant women and mothers in Great Britain has been established.

We rely on research-proven factors that have a positive impact on reproductive health:

🔹 Increasing women's awareness of pregnancy and motherhood through accessible and high-quality educational events.

🔹 Providing continuous partner and/or doula support during childbirth and the early postpartum period.

🔸 Enhancing stress resilience, supporting and strengthening mental and physical health through the integration of physical exercises and body practices into a lifestyle.

🔹 Identifying symptoms of emotional burnout, anxiety, depression, or PTSD and providing psychological support from relevant professionals.

🔸 Overcoming isolation, strengthening the sense of safety, and regaining support through ongoing contact with perinatal specialists and women who have similar experiences in closed groups.

🔹 Involving consultations and live meetings with integration experts, representatives of social services, midwives, and reproductive healthcare professionals.

The shared goal of the organizers, mentors, consultants of the Reproductive Health Program, and partners of UAEP is to promote awareness among participants regarding reproductive health and the means of supporting it, expand opportunities for the integration of displaced individuals, and develop self-reliance skills and cross-cultural competencies.