First Breaths in the Dark: How Newborn Ukrainians Are Saved in Odesa Amid Attacks and Blackouts

Despite the daily Russian attacks on Odesa, an average of five babies are born every day at the Odesa Regional Perinatal Centre. The centre cares for the most vulnerable newborns — premature babies and infants requiring intensive medical care. Doctors have learned to deliver babies during air raid alerts, work to the sound of explosions, transport their most vulnerable patients to shelters, and save their lives during blackouts. Tetiana Shporuk, a paediatrician and neonatologist who heads the Neonatal Post-Intensive Care Unit at the Odesa Regional Perinatal Centre, told the Energy Act for Ukraine Foundation team how the maternity hospital operates during the war and under the constant threat of power outages. 

Tetiana Mykhailivna, which babies do you most often have to save today?

Our patients are the smallest and most vulnerable children. Around 70% of them are premature newborns and babies with extremely low birth weights — weighing between 500 and 700 grams. The remaining 30% are babies born in critical condition, with congenital conditions or complications resulting from difficult deliveries. 

The war has undoubtedly affected the health of pregnant women. Constant stress, air raid alerts, forced displacement and disrupted sleep can all contribute to premature birth. So yes, the profile of our patients has changed: during the years of the full-scale war, the proportion of premature babies has increased by approximately 5%. 

At the same time, the overall number of births in the region is declining, as many women are moving to western Ukraine or abroad. Moreover, because of the constant attacks, the conditions in which we provide medical care have unfortunately also changed for the worse.

What are the survival prospects for premature babies, and what do they depend on?

There is no single figure or weight that definitively determines a baby’s chances. Every newborn has their own story. 

In Ukraine, babies born from the 22nd week of pregnancy and weighing at least 500 grams are officially provided with neonatal care. However, in our practice, we have also cared for babies weighing 470 grams. If there is a heartbeat, movement or any other sign of life, we do everything we can to save the child. 

Their chances depend on the gestational age, the condition of their lungs, the presence of infections or congenital conditions, the mother’s health, and how quickly the baby receives specialist care. 

Thanks to modern equipment, teamwork and the continuous improvement of treatment methods, we are now able to successfully care for even babies born with extremely low birth weights. 

This spring, a baby weighing less than one kilogram was born at your centre and was left without parental care. What happened to her?

Yes, she was a premature baby girl born at 28 weeks with a critically low birth weight of 770 grams. She spent her first 32 days in the intensive care unit before being transferred to the neonatal post-intensive care unit. 

Throughout that time, we effectively became her family. The doctors, nurses and support staff all grew deeply attached to her. 

We called her Vlada. The intensive care doctor who received her was named Vladyslav Vitaliiovych, so we began calling her after him. In her official documents, however, the girl was named Mariia. 

By the time she was discharged, Mariia weighed 2,530 grams. She was transferred to a children’s home, where she continues to gain weight and develop. She still requires treatment for associated vision problems, rehabilitation and ongoing medical supervision.

Odesa comes under attack almost every day. What happens in the unit when an air raid alert sounds?

For us, an air raid alert is not a reason to stop working. The babies cannot wait for the danger to pass. 

If a baby’s condition allows, we take them to the shelter together with portable equipment. These are primarily babies who can breathe independently and are stable enough to be transported. However, moving some babies is extremely risky. In those cases, we stay by their side and continue their treatment wherever they are. 

Armoured shutters have been installed in the intensive care unit, delivery rooms, operating theatres and the women’s intensive care unit. We press a button, and they lower automatically. The armoured shutters protect us from shrapnel and partly reduce the noise. 

Recently, air raid alerts have become so frequent that we sometimes do not even have time to raise the shutters before we have to lower them again. 

These moments are extremely difficult psychologically. We are all human, and we all have families and loved ones at home whom we worry about. But we focus on our work because a child’s life depends on what we do.

Do newborn babies react to explosions?

They do, but not in the same way as older children. A two- or three-year-old child may hear an explosion and start crying, but our youngest patients react differently. We see changes in their heart rate, while the babies themselves become very lethargic and barely respond during examinations. 

We adults also feel the blast wave. Premature babies have immature nervous systems, which makes them particularly sensitive to this kind of stress. I believe this issue has not yet been fully studied, but there is no doubt that explosions affect these infants. 

If we imagine a baby weighing less than one kilogram, which devices must operate without interruption to keep them alive?

Almost everything. 

The incubator maintains the required temperature and humidity, ventilators help the baby breathe, and monitors continuously track the baby’s heart rate, breathing and blood oxygen saturation. Infusion pumps administer medication and nutrients with exceptional precision. 

But even the most advanced equipment cannot operate without people. A team of doctors and nurses remains by each baby’s side around the clock, monitoring every change in their condition.

Have you ever had to work without electricity because of the attacks?

Yes, of course. It was truly an extreme situation. 

Whenever the power suddenly went out in the intensive care unit, the pulse oximeters, infusion pumps, heating systems and other equipment would all start beeping at once—it was a real cacophony. 

Some ventilators have internal batteries and can operate independently for a certain period of time. But you never know how long the charge will last. 

If several babies are on ventilators, there must be an Ambu bag beside each one. It is used to manually support the baby’s breathing through a mask or an endotracheal tube. At moments like these, one staff member ventilates one baby while another ventilates the second. Every available pair of hands is needed beside a patient. 

Dealing with the parents was also difficult. When the power went out, they knew their child was connected to life-support equipment, so they would rush to the intensive care unit doors to ask what was happening. Meanwhile, everyone inside was occupied: someone was manually helping a baby breathe, someone was monitoring the equipment, and someone was starting the backup power supply. On top of all that, we also had to reassure the parents. 

The generator presented a separate challenge. During the blackouts, I learned how to refuel it, start it, check the fuel level and make sure it did not run out. Before we had a fully autonomous system, we were entirely dependent on the generator, our fuel reserves and whether the electricity supply could be restored quickly. 

What changed after the solar power system was installed at the perinatal centre?

The arrival of the hybrid solar power system installed for us by the Energy Act for Ukraine Foundation completely transformed the way we work. Now, when the external power supply fails, the lights may flicker for only a moment. The equipment does not even begin to sound an alarm — the system switches over automatically, and we continue working. 

You see the lights flicker, but you know that everything is still working. There is no longer that sense of panic — where to run, what to do or whom to save first. 

Working has become much calmer and safer. You no longer think about electricity — you think about the baby. 

We tell parents from the outset that the unit has an autonomous power supply, that the equipment will continue operating even during power outages, and that the premises are fitted with armoured shutters. This is also very important to them and gives them a greater sense of security.

What does an uninterrupted power supply mean for your team when you have to care for several critically ill newborns at the same time?

We are currently caring for triplets: two brothers and a sister. Babies from multiple pregnancies are almost always born prematurely, so they require the simultaneous support of a large multidisciplinary team and medical equipment that must operate without interruption. The babies are being cared for in a unit with an uninterrupted power supply provided by the hybrid solar power system. 

The boys have already gained almost two kilograms each, while the girl, although she was born first, is still the smallest — she currently weighs 1,680 grams. The brothers are therefore ready to be discharged, but they are waiting for their sister. 

Their mother has other children who are older but still very young, so she cannot remain in the unit all the time. Our medical staff are currently providing most of the care for the triplets. 

For example, during an air raid alert, all three babies must be quickly picked up, wrapped in blankets and carried to the shelter. If the alert lasts for two or three hours, they must be fed and cared for there, while their condition is continuously monitored. This is difficult and places an additional burden on the team, but there is no other option — the safety of our smallest patients depends on it. 

What gives you the strength to return to this work every morning?

The people around me — our team — keep me going. Over the years, we have become a true family. We go through the most difficult moments together, support one another, celebrate every victory achieved by our smallest patients, and endure losses together. 

And, of course, the children give me the strength to return to work. They are very rewarding patients, and you see the results of your work fairly quickly. When a baby who was born weighing 600–700 grams was initially unable to suck independently but later begins feeding on their own, and their mother says they are already showing their personality — that is incredibly inspiring. Moments like these are exactly why you want to return to work every morning. 

I love my work, even though it is often extreme. But the most important thing is that women continue to give birth. That means life goes on.