Obtaining gynecological, childbirth, and contraception care is not easy for many people in Ukraine, and the conflict has exacerbated these access difficulties. To address this situation, Doctors of the World has set up mobile midwife teams. They go to places where there is no adequate medical care—for example, shelters for internally displaced persons and villages. The midwives provide advice, conduct primary examinations, and give patients medication if necessary. If they suspect a more serious diagnosis, they refer the person to a specialist. In some places, Doctors of the World’s mobile teams are the only way to access qualified medical services and medication.
Three of our midwives, Olena, Olha, and Olesia, working in the Dnipropetrovsk oblast, share their experiences of this reality.
For Olena Serhieienko, “We are seeing menstrual irregularities due to stress and panic attacks. Endocrine diseases—that is, hormonal and metabolic disorders—have increased. Stress-related urinary incontinence is more common among older women.
Family planning and contraception are expensive. We prescribe the pill not only for contraception but also to stabilize the cycle and normalize hormonal balance. Pills cost 500 hryvnia (19 CAD), which is a lot of money, especially for people living in rural areas. There is also high demand for our free consultation hours. Many people ask about magnesium B6 for stress. We also provide patients with hygiene products such as sanitary pads and urological pads.”
“Many women’s partners are at war,” says Olha Tokmakova. “They see their husbands less, and if they do, it’s only for a short period. In some families, there are problems with unwanted pregnancies. And families are growing even if the parents are unable to provide for these children. Today, I had four patients. One woman was pregnant. The other three want to have children but are afraid because of the war.
We refer patients with more serious illnesses to their family doctor, who then sends them for further examination. In the village of Partizanske, for example, one of our midwives referred a patient she suspected of having breast cancer. The patient underwent surgery and is now on the road to recovery.
Another patient was diagnosed with a fibromyoma, that is, a benign tumor. The doctor recommended surgery, but it costs 20,000 hryvnia (738 CAD). The average monthly salary in the municipality is 5,000 hryvnia (185 CAD). To pay for the surgery, the woman had to sell her livestock.”
One of Olesia Panfilowa’s patients had been trying to get pregnant for 17 years without success. Olesia says, “During the examination, I gave her some advice. Now she is pregnant. Stress can also have a positive effect on our bodies. The body’s tone increases, and women get pregnant more easily. However, many women are discouraged from having a child because of the fighting.”
Some facts about our midwives’ work in Ukraine:
- In 2022, our midwives in the Dnipropetrovsk oblast provided care and support to 1,009 patients during 1,286 consultations.
- In the Donetsk oblast, there were 170 patients for 519 consultations.
- 37% of patients were living below the poverty line.
- One in two patients had to flee within the country.