MICHEL MARTIN, HOST:
Ukraine is suffering from more than a Russian invasion. The birth rate has dropped significantly, which is probably not surprising, but many families with help from the government and doctors are trying to buck the trend and have a child in wartime. NPR's Ashley Westerman has this report.
ASHLEY WESTERMAN, BYLINE: Dr. Stefan Khmil has been in medicine for nearly half a century and has built a career on helping women have babies. But the last 2 1/2 years have been a challenge as Russia's full-scale invasion has upended everything. In a brightly lit operating room in his obstetrics clinic in Lviv, Dr. Khmil dons a medical gown and gloves. He takes a seat to begin a surgery he's done many, many times before.
STEFAN KHMIL: (Speaking Ukrainian).
WESTERMAN: "We're going to take the eggs," Dr. Khmil says, pointing to the ultrasound screen. He slowly guides a needle into one of the patient's ovaries to extract the liquid containing the eggs. They go into test tubes and are passed through a door to the lab, where they will be frozen to be used in in vitro fertilization treatments one day, maybe years from now.
KHMIL: (Speaking Ukrainian).
WESTERMAN: "Future Ukrainians," Khmil says, his blue eyes gleaming, "future Ukrainians." In his office, he tells us the full-scale invasion affected both patients and OB-GYN doctors who had to flee the fighting. They had to transport frozen eggs and sperm to safety, along with heavy specialized equipment.
KHMIL: (Speaking Ukrainian).
WESTERMAN: "I started thinking that we need to preserve the biological material from our military," he says, "so we started offering to freeze the spermatozoa of men serving in the military for free." Dr. Khmil's clinic is just one of many across the country to make that move. Normally, it costs thousands of U.S. dollars. Then, in 2023, Ukraine's parliament gave military men the right to have their sperm frozen at no cost.
KHMIL: (Speaking Ukrainian).
WESTERMAN: "We can give these men who are fighting the opportunity to have children after the war, during the war, whenever they want," Dr. Khmil says. The worry isn't just the number of battlefield deaths. Dr. Khmil says factors such as extreme weather, the use of chemicals and ammunition all could have a negative effect on sperm, maybe even render a man infertile.
VICTORIA ALNISCHUK: (Speaking Ukrainian).
WESTERMAN: Thirty-four-year-old Victoria Alnischuk (ph) is a patient of Dr. Khmil's and a combat medic. She drove all the way from the front line to get her eggs harvested today.
ALNISCHUK: (Speaking Ukrainian).
WESTERMAN: "I have been trying to have children since 2010," she said. When the Russians launched their full-scale invasion, the couple decided to take no chances and signed up for Dr. Khmil's free program. Alnischuk's husband is also in the military and froze his sperm some time ago. She has been taking powerful hormone medications in preparation for today.
ALNISCHUK: (Speaking Ukrainian).
WESTERMAN: "Because normally for one cycle, our body produces only one egg." But, she says, "for a successful operation, we need to harvest at least six to eight." The pills have caused her bloating, cramping and fatigue, all while doing long stints on the front. Still, Alnischuk says it's a woman's duty to give birth, especially now.
ALNISCHUK: (Speaking Ukrainian).
WESTERMAN: "We don't know what will happen to our country," she says. "And when peacetime comes, somebody will have to rebuild it." Few women think like Alnischuk. It's not just the uncertainty of war that causes them to hesitate about having a baby. For decades, Ukraine has struggled through a demographic crisis. When Ukraine became independent in 1991, its population was estimated to be about 52 million. Today, the United Nations estimates it has dropped by almost a quarter.
TYMOFII BRIK: Oh, I think it's a bit of everything.
WESTERMAN: That's Tymofii Brik, the rector of Kyiv School of Economics, explaining why. Ukrainian men have some of the highest mortality rates in Europe, he says. Immigration for work and a safer life is another cause of the shrinking population. And Ukraine is a modern, industrialized and educated society.
BRIK: When you have these kinds of societies, usually plans and ideas of your life also change. Usually, people do not plan to have a lot of kids.
WESTERMAN: Brik says when the war ends, Ukraine will have to work hard to make families feel safe enough to not only have children but to have more children than before. Until then, some families feel they cannot wait. So they turn to doctors like Dr. Stefan Khmil, who says he has helped 65 children be born since Russia's latest invasion. We traveled to the city of Ternopil to meet two of them.
(SOUNDBITE OF BABY COOING)
WESTERMAN: Five-month-old twins Gaylena (ph) and Artur (ph) were born through in vitro fertilization.
KHMIL: (Speaking Ukrainian).
WESTERMAN: "No, no, no, no - don't cry," Dr. Khmil tells the little girl. Their mother, 48-year-old Svitlana Talynuk (ph), says even though she and her husband already had two boys, they wanted more.
SVITLANA TALYNUK: (Speaking Ukrainian).
WESTERMAN: "But we didn't have time because the war started and he went to fight," she says. "He was only home a couple of days."
(SOUNDBITE OF BABY COOING)
WESTERMAN: So the couple decided to freeze his sperm in January of 2023. But these babies will never meet their father. Talynuk found out she was pregnant just days after going to his funeral.
TALYNUK: (Speaking Ukrainian).
WESTERMAN: "The boy is an absolute copy of my husband," she says, "an identical copy."
(SOUNDBITE OF BABY COOING)
WESTERMAN: He smiles, his chubby cheeks turning red and his brown eyes twinkling. Talynuk says she's proud. She wants to raise the twins by herself, like so many other Ukrainian women. Dr. Khmil says life in Ukraine will likely not be easy for these mothers and their children born during war. But he sees helping families have kids as a way of doing his part to save his country.
Ashley Westerman, NPR News, Lviv, Ukraine.
(SOUNDBITE OF OSKAR SCHUSTER'S "VLEURGAT") Transcript provided by NPR, Copyright NPR.
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